Does This Patient Have Hypertension?

Reeves, Richard

doi:10.1001/jama.1995.03520390071036

Cited by 131 publications

(26 citation statements)

References 106 publications

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“…The manual BP reading determined final eligibility for the study. 35 Patients with stage 1 or stage 2 hypertension (SBP ϭ 141-179 mm Hg and/or DBP ϭ 91-109 mm Hg) were excluded from the study so as to maximize the contrast between our two study groups, patients with controlled hypertension and patients with severe uncontrolled hypertension.…”

Section: Measurementsmentioning

confidence: 99%

Correlates of Controlled Hypertension in Indigent, Inner-City Hypertensive Patients

1997

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OBJECTIVE:To identify correlates of controlled hypertension in a largely minority population of treated hypertensive patients. DESIGN:Case-control study. SETTING: Urban, public hospital.PATIENTS: A consecutive sample of patients who were aware of their diagnosis of hypertension for at least 1 month and had previously filled an antihypertensive prescription. Control patients had a systolic blood pressure (SBP) Յ 140 mm Hg and diastolic blood pressure (DBP) Յ 90 mm Hg, and case patients had a SBP Ն 180 mm Hg or DBP Ն 110 mm Hg. 96; 0.99, 3.88). A secondary analysis found that patients with Medicaid coverage were significantly less likely than the uninsured to report cost as a barrier to purchasing antihypertensive medications and seeing a physician. MEASUREMENTS AND MAIN RESULTS: CONCLUSIONS:The absence of out-of-pocket expenditures under Medicaid for medications and physician care may contribute significantly to BP control. Improved access to a regular source of care and increased sensitivity to medication costs for all patients may lead to improved BP control in an indigent, inner-city population.KEY WORDS: inner-city patients; hypertension; access to care; regular source of care.

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Section: Measurementsmentioning

confidence: 99%

Correlates of Controlled Hypertension in Indigent, Inner-City Hypertensive Patients

1997

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“…Use of a single clinic measurement may over-diagnose hypertension in up to 30% of the general population [11-13]; in many patients identified by conventional criteria as having hypertension, this increase in BP is confined to the clinic setting and described as 'white-coat hypertension’ [14,15]. If 'white-coat hypertension’ is not correctly identified, patients may subsequently receive unnecessary antihypertensive treatment [16].…”

Section: Introductionmentioning

confidence: 99%

Optimising the accuracy of blood pressure monitoring in chronic kidney disease: the utility of BpTRU

et al. 2013

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Background: Accurate blood pressure monitoring is critical for the management of chronic kidney disease, but changes in management in secondary care clinics may be based on a single blood pressure reading, with a subsequent lack of accuracy. The aim of this study was to evaluate a fully automated sphygmomanometer for optimising the accuracy of blood pressure measurements in the setting of secondary care renal clinics.

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“…Regarding which specific physical examination skills should be emphasized, JAMA has published an ongoing series of critical reviews entitled the "Rational Clinical Examination," [8][9][10][11][12][13][14][15][16][17][18][19] and this information can help guide the selection of specific skills that deserve emphasis. To identify those specific skills which should be targeted for improvement in instruction, we should know the skills in which physicians, residents, and medical students are least confident in their ability, as well as those skills that they view as being most important.…”

Section: Introductionmentioning

confidence: 99%

Self-Confidence in and Perceived Utility of the Physical Examination: A Comparison of Medical Students, Residents, and Faculty Internists

Fagan

Reinert

et al. 2007

J GEN INTERN MED

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BACKGROUND AND OBJECTIVES:Little is known about the differences in attitudes of medical students, Internal Medicine residents, and faculty Internists toward the physical examination. We sought to investigate these groups' self-confidence in and perceived utility of physical examination skills. DESIGN AND PARTICIPANTS:Cross-sectional survey of third-and fourth-year medical students, Internal Medicine residents, and faculty Internists at an academic teaching hospital. MEASUREMENTS:Using a 5-point Likert-type scale, respondents indicated their self-confidence in overall physical examination skill, as well as their ability to perform 14 individual skills, and how useful they felt the overall physical examination, and each skill, to be for yielding clinically important information. RESULTS:The response rate was 80% (302/376). The skills with overall mean self-confidence ratings less than "neutral" were interpreting a diastolic murmur (2.9), detecting a thyroid nodule (2.8), and the nondilated fundoscopic examination using an ophthalmoscope to assess retinal vasculature (2.5). No skills had a mean utility rating less than neutral. The skills with the greatest numerical differences between mean self-confidence and perceived utility were distinguishing between a mole and melanoma (1.5), detecting a thyroid nodule (1.4), and interpreting a diastolic murmur (1.3). Regarding overall self-confidence, third-year students' ratings (3.3) were similar to those of first-year residents (3.4; p=.95) but less than those of fourth-year students (3.8; p=.002), upper-level residents (3.7; p=.01), and faculty Internists (3.9; p<.001).CONCLUSIONS: Self-confidence in the physical exam does not necessarily increase at each stage of training. The differences found between self-confidence and perceived utility for a number of skills suggest important areas for educational interventions.

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Does This Patient Have Hypertension?

Cited by 131 publications

References 106 publications

Correlates of Controlled Hypertension in Indigent, Inner-City Hypertensive Patients

Correlates of Controlled Hypertension in Indigent, Inner-City Hypertensive Patients

Optimising the accuracy of blood pressure monitoring in chronic kidney disease: the utility of BpTRU

Self-Confidence in and Perceived Utility of the Physical Examination: A Comparison of Medical Students, Residents, and Faculty Internists

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