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The impact of multiple comorbidities on overall quality of care in outpatients is not well described. To assess the effects of coexisting conditions on the management of hypertension, investigators studied electronic medical records from six primary care practices. Patients were 18 years or older and had at least three follow-up visits after being diagnosed with hypertension.
In 70,557 visits to 200 clinicians, 15,459 patients (more than half of them women or black) had uncontrolled hypertension. Providers intensified antihypertensive treatment in 31% of these patients. Comorbidities unrelated to hypertension were absent at only 17% of study visits (mean number per study visit, 2.2). Before and after multivariable adjustment, unrelated comor…