Abstract P190: Management Of Patients With Hypertension: Challenges From A Student-Run Free Clinic

Abstract

Background/Objectives: The Anne Kastor Brooklyn Free Clinic (BFC) is a student-run free clinic affiliated with the SUNY Downstate Health Sciences University which provides healthcare to the uninsured and represents patients from all five boroughs of New York City. Through this research, we were able to identify improvements for the management and care of a prevalent condition in a community which is both disadvantaged and underserved. Methods: De-identified data on patient visits were aggregated from the electronic health record of the BFC from 2020-2022 and organized into a database using Redcap. We analyzed chief complaints, prescriptions, symptoms, comorbidities, and demographics for patients with hypertension at the BFC during this time period. Results: Our analysis included 121 patients in 311 total visits. The average blood pressure for patients with hypertension was 144/83 (stage 2 hypertension). 18.9% of patients were obese, with an average BMI of 33.1 (SD: 9.76). Most patients presented for a general check-up (67.5%) or for cardiovascular concerns (15.1%) at an in-person visit (67.8%). Patients were predominantly female (63.6%), black (38.0%), non-smokers (69.1%) with a history of diabetes (24.6%) and alcohol use (26.4%). Patients frequently had hypertension (49.6%) and type II diabetes (38.0%) within the family. Physicians noted a common physical exam finding of lower extremity edema (15.1%) and frequently ordered HbA1c (30.4%) and lipid panel (29.2%) labs. 42.2% of patients were on medications to control their hypertension, and 25.3% of visits included a prescription of antihypertensive medications. 86.5% of visits included lifestyle counseling. Most patients were scheduled for a follow-up (80.6%). Conclusion: Many patients presented with poorly-treated chronic illnesses, leading to an increase in cardiovascular complications like hypertension. A minority of patients were taking medications to control their hypertension, and fewer were prescribed antihypertensives at their visit, suggesting the need for improved pharmacologic management of hypertension in addition to lifestyle counseling. Patients should also be encouraged to present in-person to assess for pitting edema and other cardiovascular concerns.