The association between hypertension treatment,control, and functional status

The authors examined the relationship between hypertension treatment, control, and functional status among 356 “uncomplicated” hypertensive patients receiving care in 16 teaching hospital group ractices. Antihypertensive drug therapy and blood pressure control were determined from a medical record review. Functional status (health perceptions, mental health, role, and physical functioning) was assessed with a questionnaire. After adjustment for potential confounders, hypertensive patients without drug therapy were less likely to have impairment in mental health functioning, compared with patients receiving one or more than one antihypertensive medication (9% versus 25% and 20%, respectively, p<0.05). However, uncontrolled hypertensive patients were more likely to have role limitations than patients controlled only at the end or throughout the record review period (51% versus 39% and 36%, respectively, p<0.05). Patients controlled throughout the review period had the least impairment for each measure of functional status. These preliminary findings suggest that pharmacologic therapy may have a negative influence on the mental health of “uncomplicated” hypertensive patients, but that the dual goals of blood pressure control and positive functional status are not incompatible. Presented in part at the American Federation for Clinical Research Annual Meeting, May 1986. Supported by a grant from the Robert Wood Johnson Foundation. The conclusions are those of the authors and do not necessarily reflect the opinion of the Robert Wood Johnson Foundation or the Rand Corporation. Dr. Siscovick was a Teaching and Research Scholar of the American College of Physicians and an NHLBI Preventive Cardiology Academic Awardee.