We demonstrated that a multidisciplinary clinic for difficult-to-control blood pressure can be successful in a public health setting serving a disadvantaged minority population. Our success rate over 6 months of 58% compares favorably to the success rate (64%) in a private setting that serves primarily well-educated, Caucasian patients. The fact that eleven subjects of fifty [...]

The characteristics of the first fifty patients enrolled in the clinic are described in Table 1. The typical patient was a 60-year-old diabetic African-American woman with a history of hypertension for 18 years taking 4 different antihypertensive medications, including a diuretic, calcium-channel blocker, alpha-blocker, and ACE-inhibitor. Of the fifty patients, 33 (66%) were female and [...]

A multidisciplinary hypertension clinic was established in the summer of 2000 to treat patients with difficult-to-control hypertension within the Cook County ambulatory health care network. The team of providers included three general internists, a nurse health educator, pharmacist, and dietician. Eligible patients with difficult-to-control hypertension were defined as having blood pressure persistently greater than 140 [...]

INTRODUCTION
The treatment of difficult-to-control hypertension in disadvantaged populations—poor, urban, or ethnically diverse—is a challenge that few individual practitioners or institutions have successfully addressed. This is a public health issue of significant importance, as uncontrolled hypertension leads to increased health care expenditures as well as higher rates of morbidity and mortality. The high prevalence of poor [...]

Numerous published reports have documented ethnic differences in the receipt and outcomes of care between African-American and Caucasian patients in a variety of settings. Many of these studies have been based upon administrative data relating to hospitalization. This analysis represents one of the few attempts to investigate the existence of such differences in the primary [...]

At enrollment into ACQUIP, the health-screening questionnaire was sent to 55,222 patients, of whom 32,149 were Caucasian and 12,816 were African-American. A total of 31,360 were returned, including 10,385 Caucasian and African-American patients, who reported ischemic heart disease and were sent the SAQ. Responses were received from 7,985 of these patients, of whom 6,704 (84.0%) [...]

Design
We performed a cross-sectional analysis of baseline data collected as part of the Ambulatory Care Quality Improvement Project (ACQUIP). ACQUIP was a multicenter, group-randomized trial designed to determine whether health outcomes and satisfaction with care could be improved by giving primary care providers access to regular, systematic assessments of their patients’ health and functional status, [...]