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Ethnic differences in blood pressure control among men at Veterans Affairs clinics and other health care sites.
Arch Intern Med. 2005 May 09; 165(9):1041-7.AI

Abstract

BACKGROUND

Differential access to health care may contribute to lower blood pressure (BP) control rates to under 140/90 mm Hg in African American compared with white hypertensive patients, especially men (26.5% vs 36.5% of all hypertensive patients in the National Health and Nutrition Examination Survey 1999-2000). The Department of Veterans Affairs (VA) system, which provides access to health care and medications across ethnic and economic boundaries, may reduce disparities in BP control.

METHODS

To test this hypothesis, BP treatment and control groups were compared between African American (VA, n = 4379; non-VA, n = 2754) and white (VA, n = 7987; non-VA, n = 4980) hypertensive men.

RESULTS

In both groups, whites were older than African Americans (P<.05), had lower BP (P<.001), and had BP controlled to below 140/90 mm Hg more often on their last visit (P<.01). Blood pressure control to below 140/90 mm Hg was comparable among white hypertensive men at VA (55.6%) and non-VA (54.2%) settings (P = .12). In contrast, BP control was higher among African American hypertensive men at VA (49.4%) compared with non-VA (44.0%) settings (P<.01), even after controlling for age, numerous comorbid conditions, and rural-urban classification. African American hypertensive men received a comparable number of prescriptions for BP medications at VA sites (P = .18) and more prescriptions at non-VA sites than did whites (P<.001). African Americans had more visits in the previous year at VA sites (P<.001) and fewer visits at non-VA sites (P<.001) compared with whites.

CONCLUSIONS

The ethnic disparity in BP control between African Americans and whites was approximately 40% less at VA than at non-VA health care sites (6.2% vs 10.2%; P<.01). Ensuring access to health care could constitute one constructive component of a national initiative to reduce ethnic disparities in BP control and cardiovascular risk.

Authors+Show Affiliations

Department of Medicine, Ralph H. Johnson VA Medical Center, Charleston, SC 29401, USA. shakaib.rehman@med.va.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15883244

Citation

Rehman, Shakaib U., et al. "Ethnic Differences in Blood Pressure Control Among Men at Veterans Affairs Clinics and Other Health Care Sites." Archives of Internal Medicine, vol. 165, no. 9, 2005, pp. 1041-7.
Rehman SU, Hutchison FN, Hendrix K, et al. Ethnic differences in blood pressure control among men at Veterans Affairs clinics and other health care sites. Arch Intern Med. 2005;165(9):1041-7.
Rehman, S. U., Hutchison, F. N., Hendrix, K., Okonofua, E. C., & Egan, B. M. (2005). Ethnic differences in blood pressure control among men at Veterans Affairs clinics and other health care sites. Archives of Internal Medicine, 165(9), 1041-7.
Rehman SU, et al. Ethnic Differences in Blood Pressure Control Among Men at Veterans Affairs Clinics and Other Health Care Sites. Arch Intern Med. 2005 May 9;165(9):1041-7. PubMed PMID: 15883244.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ethnic differences in blood pressure control among men at Veterans Affairs clinics and other health care sites. AU - Rehman,Shakaib U, AU - Hutchison,Florence N, AU - Hendrix,Katharine, AU - Okonofua,Eni C, AU - Egan,Brent M, PY - 2005/5/11/pubmed PY - 2005/6/9/medline PY - 2005/5/11/entrez SP - 1041 EP - 7 JF - Archives of internal medicine JO - Arch Intern Med VL - 165 IS - 9 N2 - BACKGROUND: Differential access to health care may contribute to lower blood pressure (BP) control rates to under 140/90 mm Hg in African American compared with white hypertensive patients, especially men (26.5% vs 36.5% of all hypertensive patients in the National Health and Nutrition Examination Survey 1999-2000). The Department of Veterans Affairs (VA) system, which provides access to health care and medications across ethnic and economic boundaries, may reduce disparities in BP control. METHODS: To test this hypothesis, BP treatment and control groups were compared between African American (VA, n = 4379; non-VA, n = 2754) and white (VA, n = 7987; non-VA, n = 4980) hypertensive men. RESULTS: In both groups, whites were older than African Americans (P<.05), had lower BP (P<.001), and had BP controlled to below 140/90 mm Hg more often on their last visit (P<.01). Blood pressure control to below 140/90 mm Hg was comparable among white hypertensive men at VA (55.6%) and non-VA (54.2%) settings (P = .12). In contrast, BP control was higher among African American hypertensive men at VA (49.4%) compared with non-VA (44.0%) settings (P<.01), even after controlling for age, numerous comorbid conditions, and rural-urban classification. African American hypertensive men received a comparable number of prescriptions for BP medications at VA sites (P = .18) and more prescriptions at non-VA sites than did whites (P<.001). African Americans had more visits in the previous year at VA sites (P<.001) and fewer visits at non-VA sites (P<.001) compared with whites. CONCLUSIONS: The ethnic disparity in BP control between African Americans and whites was approximately 40% less at VA than at non-VA health care sites (6.2% vs 10.2%; P<.01). Ensuring access to health care could constitute one constructive component of a national initiative to reduce ethnic disparities in BP control and cardiovascular risk. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/15883244/Ethnic_differences_in_blood_pressure_control_among_men_at_Veterans_Affairs_clinics_and_other_health_care_sites_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.165.9.1041 DB - PRIME DP - Unbound Medicine ER -