American journal of preventive medicine
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Comparative Study
Hypertension control in a rural southern community: medical care process and dropping out.
As part of the Edgecombe County High Blood Pressure Control Program, we conducted a medical record review within a private group practice to assess the interrelationships between patient characteristics, the process of medical care, and dropping out of care by hypertensive patients. Twenty-one percent of 641 randomly selected hypertensive patients did not have a clinic visit in the year before their record review date. Loss to follow-up varied from 31% for black men to 13% for white women. ⋯ Black men were much less likely to have intense contact with the medical care system than the other groups. Physician aggressiveness in the use of drug therapy was associated with a nearly 40% reduction in the risk of being lost to follow-up. These findings suggest that patient characteristics and several factors that reflect the process of medical care are associated with dropping out of medical care by hypertensive patients.
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Comparative Study
Beliefs among black and white adults about causes and prevention of cardiovascular disease: the Minnesota Heart Survey.
We assessed beliefs about the symptoms, causes, and prevention of cardiovascular disease in population-based surveys of black and white Twin Cities adults in 1985-86. Whites had a generally higher awareness of heart attack symptoms than did blacks; 72% of blacks and 85% of whites mentioned chest pain as a likely symptom. Sixty-five percent of blacks and 76% of whites correctly offered at least one of the three major, modifiable risk factors (smoking, hypertension, and high cholesterol in blood or diet) as likely causes of cardiovascular disease. ⋯ After accounting for differences in educational level, blacks demonstrated a higher awareness of hypertension as a risk factor, whereas whites were more knowledgeable about smoking and cholesterol. In light of the high percentage of adults still lacking awareness about cardiovascular risk, public education about prevention should continue. Such efforts are broadly desirable but may be most effectively targeted toward minorities and groups with less education, in whom awareness is low and risk of disease is high.