Background: Little is known about the adequacy of screening for and treatment of hypertension for people with developmental disabilities (DD). Pharmacists may assist in identifying and treating this special patient population. Objective: To characterize and compare the screening, treatment, and control of blood pressure (BP) in patients with DD to patients without DD. Methods: This retrospective study identified adult patients of primary care practices within a large academic health system who had DD (DD group) and a comparator group without DD (GenMed group). Outcomes assessed included percentage of patients screened, mean BP, percentage of patients with controlled BP, and antihypertensive medications prescribed. Results: The DD (n = 183) and GenMed groups (n = 497) were nearly all screened for BP. Mean systolic BP was significantly lower in the DD group (119.9 ± 14.6 mm Hg vs 122.8 ± 15.4 mm Hg GenMed, P = .03), while diastolic BP was no different (P = .7). Stroke was documented significantly more often in the DD group (5.5% vs 1.4%, P = .005). Of patients with uncontrolled BP, the DD group had significantly higher systolic BP (155.8 ± 14.1 mm Hg vs 147.4 ± 9.5 mm Hg GenMed, P = .02). Hypertension was documented in 32% of DD group versus 38.5% of GenMed group, P = .15. Of this group, 88.1% of the DD group had controlled BP versus 78.0% of the GenMed group, P = .09. Antihypertensive prescribing was not different between the groups. Conclusion: DD group patients had similar outcomes for hypertension therapy compared to patients without DD. Those with uncontrolled BP in the DD group tended to have higher systolic BP. Significantly more DD patients had a history of stroke.
BraddockDHempRRizoloMCTanisEHafferLWuJ.The State of the States in Intellectual and Developmental Disabilities: Emerging From the Great Recession. 10th ed.Washington, DC: American Association on Intellectual and Developmental Disabilities; 2015.
2.
GillespieCKuklinaEBrissPBlairNAHongY.Vital signs: prevalence, treatment, and control of hypertension—United States, 1999-2002 and 2002-2008. MMWR Morb Mortal Wkly Rep. 2011;60(4):103-108.
3.
RogerVGoALloyd-JonesD. Heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation. 2012;125:e2-e220.
4.
HendersonCMRobinsonLMDavidsonPWHavemanMJanickiMPAlbertiniG.Overweight status, obesity, and risk factors for coronary heart disease in adults with intellectual disability. J Policy Practice Intellect Disabil. 2008;5:174-177.
5.
DraheimCC.Cardiovascular disease prevalence and risk factors of persons with mental retardation. Ment Retard Ded Disabil Res Rev. 2006;12:3-12.
6.
WallaceRASchluterP.Audit of cardiovascular disease risk factors among supported adults with intellectual disability attending an ageing clinic. J Intellect Dev Disabil. 2008;33:48-58.
7.
WellsMBTurnerSMartinDMRoyA.Health gain through screening—coronary heart disease and stroke: developing primary health care services for people with intellectual disability. J Intellect Dev Disabil. 1997;22:251-263.
8.
TylerCVSchrammSCKarafaMTangASJainAK.Chronic disease risks in young adults with autism spectrum disorder: forewarned is forearmed. Am J Intellect Dev Disabil. 2011;116:371-380.
9.
StraussDCableWShavelleR.Causes of excess mortality in cerebral palsy. Dev Med Child Neurol. 1999;41:580-585.
10.
PrasherV.Screening of medical problems in adults with Down syndrome. Down Syndrome Res Pract. 1994;2:59-66.
11.
JamesPAOparilSCarterBL. 2014 evidence-based guideline for the management of high blood pressure in adults. Report from the panel members appointed to the Eighth Joint National Committee (JNC8). JAMA. 2014;311:507-520. doi:10.1001/jama.2013:284427.
12.
BraddockD.Aging and developmental disabilities: demographic and policy issues affecting American families. Ment Retard. 1999;37:155-161.
13.
JanickiMPDaltonAJHendersonCMDavidsonPW.Mortality and morbidity among older adults with intellectual disability: health services considerations. Disabil Rehabil. 1999;21:284-294.
14.
WilkinsonJECulpepperLCerretoM.Screening tests for adults with intellectual disabilities. J Am Board Fam Med. 2007;20:399-407.
15.
BarrOGilgunnJKaneTMooreG.Health screening for people with learning disabilities by a community learning disability nursing service in Northern Ireland. J Adv Nurs. 1999;29:1482-1491.
16.
EganBMLiJHutchisonFNFerdinandKC.Hypertension in the United States, 1999 to 2012. Progress toward Healthy People 2020 goals. Circulation. 2014;130:1692-1699.
17.
StevensACourtney-LongEGillespieCArmourBS. Hypertension among US adults by disability status and type, National Health and Nutrition Examination Survey, 2001-2010. Prev Chronic Dis. 2014;11:E139. doi:10.5888/pcd11.140162.
18.
de WinterCFMagilsenKWvan AlfenJCPenningCEvenhuisHM.Prevalence of cardiovascular risk factors in older people with intellectual disability. Am J Intellect Dev Disabil. 2009;114:427-436.
19.
de WinterCFBastianseLPHilgenkampTIMEvenhuisHMEchteldMA.Cardiovascular risk factors (diabetes, hypertension, hypercholesterolemia and metabolic syndrome) in older people with intellectual disability: results of the HA-ID study. Res Dev Disabil. 2012;33:1722-1731.
20.
VacekJLHuntSLShiremanT.Hypertension medication use and adherence among adults with developmental disability. Disabil Health J. 2013;6:297-302.
