Characteristics of Visits to Primary Care Physicians by Adults Diagnosed With Hypertension.

Objective-This report describes the demographic, state, and regional differences in hypertension control and pharmaceutical treatment among visits to primary care physicians made by hypertensive adults during 2013-2014. Methods-Data are from the 2013-2014 National Ambulatory Medical Care Survey (NAMCS), a nationally representative survey of visits to nonfederal, office-based physicians. The sample design for the 2013-2014 NAMCS included oversampling in selected states. Estimates are provided for the 18 states oversampled in both years. Estimates are also presented for the nine census divisions. The study population includes all primary care physician visits made by nonpregnant adults who have hypertension, as defined by documentation of hypertension in their medical record. Hypertensive visits indicating hypertension control as well as those with mention of a hypertensive medication were examined by selected demographic characteristics as well as by region and state. Sample weights were applied to each case to provide national estimates of health care utilization. Results-During 2013-2014, in the United States, hypertension control was indicated [a blood pressure (BP) measurement of less than 140/90 mm Hg] at an estimated 66.0% of hypertensive visits. There was mention of at least one hypertensive medication documented in the medical record at 72.0% of hypertensive visits. Hypertension control was indicated at a lower percentage of hypertensive visits made by non-Hispanic black persons (57.4%) than hypertensive visits made by all other racial or ethnic groups. Hypertension was under control or there was mention of a hypertensive medication at a lower percentage of hypertensive visits made by adults aged 18-44 than hypertensive visits by older adults. The percentage of visits with an indication of hypertension control varied widely by state (ranging from 53.7% in Tennessee to 73.2% in Florida) and region (ranging from 60.1% in the East South Central division to 71.1% in the New England division). Among the 18 states, the percentage of hypertensive visits that had mention of a hypertensive medication ranged from 57.1% in Georgia to 85.0% in Washington. Conclusion- The demographic and geographical differences identified in this report may help inform state and local policies aimed at controlling hypertension.