Missed opportunities in CVD prevention? Women with elevated blood pressures in OB/GYN clinics are less likely to be recognized as hypertensive [presentation] Presentation uri icon
  • Background/Aims : Many younger women use obstetrician-gynecologist (OBGYN) clinics as their primary source of health care, however, the role of OBGYNs in CVD prevention is largely unexplored. The aim of this study is to compare hypertension recognition rates in young women who present with elevated blood pressures in OBGYN to rates in Medicine (family practice and internal medicine) clinics.
    Methods : The study population consisted of patients in the Cardiovascular Research Network (CVRN) Hypertension Registry from Kaiser Permanente Northern California and Kaiser Permanente Colorado. Women ages 18-49 with incident hypertension between 2002 and 2006 based on two consecutive elevated blood pressures of SBP >140mmHg and/or DBP >90 mmHg were included. Women whose hypertension was associated with pregnancy were excluded. Multivariable logistic regression assessed the association between hypertension recognition (defined as an ICD-9 diagnosis of hypertension and/or a prescription for an antihypertensive medication within one year of the second elevated blood pressure) with the type of clinic where the second consecutive elevated blood pressure was recorded (i.e. where the patient first presented with hypertension).
    Results : Of the 34,627 women with incident hypertension, 33% first presented with hypertension at an OBGYN clinic and 67% first presented with hypertension at a Medicine clinic. The unadjusted rates of hypertension recognition varied significantly by clinic category: 40% of women who first presented with hypertension at Medicine clinic were recognized within one year, compared to 23% who first presented with hypertension at OBGYN clinic (p<.0001). After adjusting for SBP levels and other patient characteristics, women who presented with hypertension in OBGYN were substantially less likely to be recognized as having hypertension within a year than those who presented in Medicine (OR = 0.43; 95% CI = (0.41, 0.46)).
    Conclusion : Many young women present with elevated blood pressures in OBGYN clinics, and this was associated with lower recognition of hypertension. These findings suggest that there may be opportunities to improve the recognition and treatment of CVD risk factors for young women cared for by OBGYNs.

  • participant
  • Bibbins-Domingo, K.   Presenter  
  • Daugherty, S. L.   Presenter  
  • Ho, P. M.   Presenter  
  • Leong, T. K.   Presenter  
  • Magid, D. J.   Presenter  
  • Margolis, Karen L., MD, MPH   Presenter  
  • O'Connor, Patrick J., MD, MA, MPH   Presenter  
  • Schmittdiel, J. A.   Presenter  
  • Selby, J. V.   Presenter  
  • Swain, B. E.   Presenter  
  • Research
  • Cardiovascular Diseases
  • Hypertension
  • Prevention
  • Risk Factors