Continuity of care and hypertension control in a university-based practice

Objectives: We describe the relationship between continuity of care and control of hypertension. Design: Retrospective longitudinal cohort study of adults with hypertension. Setting: University of North Carolina Family Medicine Center. Patients: Hypertensive patients making at least four visits to the Center during a two-year period, 1999-2001. Main Outcome Measures: Longitudinal blood pressure level and dichotomous (<140 systolic and <90 systolic) blood pressure control. Independent variables include continuity of care, race and other demographic information, type of primary provider, and insurance type. Results: Both systolic and diastolic BP fell over the two years (systolic 2.2 mm Hg/year and diastolic 2.8 mm Hg/year). Lower systolic blood pressure was not associated with continuity of care, sex or provider type (faculty vs. resident). Lower diastolic blood pressure had a borderline association with continuity of care (2.2 mm Hg/year, 95% Cl -4.7,0.4). Higher vs. lower continuity of care showed a trend toward better BP control, but the results were not significant (OR 0.84, 95% Cl 0.65,1.09). Lower blood pressures were associated with Caucasian race (vs African American race). Conclusions: Continuity of care was not related to control of hypertension at our center. The factors related to hypertension control need further research.