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Cardiovascular disease (CVD) is the leading cause of death and disability in U.S. women. Treatment of hypertension is a key component of CVD prevention. Obstetrics and gynecology (OB/GYN) clinics are an important — and, at times, sole — source of primary care for many young women. Accordingly, researchers used data from 34,627 women (age range, 18–49) who received care through Kaiser Permanente in northern California and Colorado to examine whether recording of a second consecutive elevated blood pressure (BP) at an OB/GYN clinic versus a medicine clinic affected likelihood that hypertension would be recognized (i.e., diagnosed and treated) within the following year.
Overall, only 33% of women received diagnoses of or treatment for hypertension within 1 year of a second consecutive elevated BP reading. After adjusting for patient age, systolic BP, and race or ethnicity, women with two consecutive elevated BP readings in OB/GYN clinics, compared with medicine clinics, were significantly less likely to be recognized as hypertensive (odds ratio, 0.51). Similar trends in recognition were observed for women with three consecutive elevated BP measurements (30% of those seen at OB/GYN clinics vs. 51% seen at medicine clinics).
Schmittdiel J et al. Missed opportunities in cardiovascular disease prevention? Low rates of hypertension recognition for women at medicine and obstetrics-gynecology clinics. Hypertension 2011 Apr; 57:717.
Comment
Although the authors did not assess receipt of counseling for lifestyle modification, consider whether patients were seen by physicians or by midlevel providers, or determine whether women were seeking care for painful or anxiety-provoking conditions, these findings highlight an ongoing need for vigilance concerning hypertension among young women, especially by clinicians in OB/GYN clinics.