Care for women with high blood pressure falls short

Study also demonstrates link between quality of care and blood pressure control

SANTA MONICA, Calif., May 28 – The quality of care for women with high blood pressure falls considerably short of the standards set by a panel of medical experts, according to a RAND report published today in Archives of Internal Medicine. The study found that the average woman with high blood pressure receives less than two thirds of the essential, scientifically validated care processes she needs.

“Our results also showed a clear relationship between better care processes and better blood pressure control,” said lead researcher Steven M. Asch, M.D. “While our study only covered women, there is no reason to suspect that care for men would show a significantly different pattern.” In addition to being a member of the RAND staff, Asch is a physician with the Veterans Affairs Greater Los Angeles Health Care System and the UCLA Department of Medicine.

The experts’ recommendations are part of a new and comprehensive quality measurement system called QATools. The system’s hypertension quality indicators include screening for high blood pressure at physician visits, diagnostic evaluation, appropriate therapies, adequate monitoring of treatment and response over time, control of blood pressure levels and provision of adequate follow-up.

The study evaluated care based on the medical records of 613 women patients enrolled in a West Coast managed care plan. Blood pressure screening of these patients by health personnel in the plan occurred at rates of over 80 percent.

But of the 234 women in the group who had been diagnosed as hypertensive or who had an average blood pressure greater than 140/90 mm Hg during the study period, most did not receive an adequate initial history, physical examination or laboratory tests. And only 37 percent of those with persistently high blood pressure (>160/90) were advised to make changes in their therapy or in their lifestyles.

“Failure to control blood pressure represents a serious health risk,” noted senior author Elizabeth A. McGlynn, Ph.D. “Nearly 70,000 deaths annually could be prevented with better blood pressure control.” McGlynn is the director of RAND’s Center for Research on Quality in Health Care.

The study was made possible by grants from the Health Care Financing Administration and Bristol Myers Squibb. For a copy of the Archives article, contact RAND’s Public Information Office 310-451-6913.

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis.

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For more information contact: Jess Cook, RAND, 310-451-6913 or Lori Vadala, Porter Novelli, 212-601-8263.