Volume 52 | Number 2 | April 2017

Abstract List

Valy Fontil M.D., M.A.S., Kirsten Bibbins‐Domingo Ph.D., M.D., M.A.S., Oanh Kieu Nguyen M.D., M.A.S., David Guzman M.S., Lauren Elizabeth Goldman M.D., M.C.R.


To examine adherence to guideline‐concordant hypertension treatment practices at community health centers (s) compared with private physicians' offices.

Data Sources/Study Setting

National Ambulatory Medical Care Survey from 2006 to 2010.

Study Design

We examined four guideline‐concordant treatment practices: initiation of a new medication for uncontrolled hypertension, use of fixed‐dose combination drugs for patients on multiple antihypertensive medications, use of thiazide diuretics among patients with uncontrolled hypertension on ≥3 antihypertensive medications, and use of aldosterone antagonist for resistant hypertension, comparing use at with private physicians' offices overall and by payer group.

Data Collection/Extraction Methods

We identified visits of nonpregnant adults with hypertension at s and private physicians' offices.

Principal Findings

Medicaid patients at s were as likely as privately insured individuals to receive a new medication for uncontrolled hypertension ( 1.0, 95 percent : 0.6–1.9), whereas Medicaid patients at private physicians' offices were less likely to receive a new medication ( 0.3, 95 percent : 0.1–0.6). Use of fixed‐dose combination drugs was lower at s ( 0.6, 95 percent : 0.4–0.9). Thiazide use for patients was similar in both settings ( 0.8, 95 percent : 0.4–1.7). Use of aldosterone antagonists was too rare (2.1 percent at s and 1.5 percent at private clinics) to allow for statistically reliable comparisons.


Increasing physician use of fixed‐dose combination drugs may be particularly helpful in improving hypertension control at s where there are higher rates of uncontrolled hypertension.