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Racial differences in blood pressure control: potential explanatory factors.
Am J Med. 2006 Jan; 119(1):70.e9-15.AJ

Abstract

PURPOSE

Poor blood pressure control remains a common problem that contributes to significant cardiovascular morbidity and mortality, particularly among African Americans. We explored antihypertensive medication adherence and other factors that may explain racial differences in blood pressure control.

METHODS

Baseline data were obtained from the Veteran's Study to Improve The Control of Hypertension, a randomized controlled trial designed to improve blood pressure control. Clinical, demographic, and psychosocial factors relating to blood pressure control were examined.

RESULTS

A total of 569 patients who were African American (41%) or white (59%) were enrolled in the study. African Americans were more likely to have inadequate baseline blood pressure control than whites (63% vs 50%; odds ratio = 1.70; 95% confidence interval [CI] 1.20-2.41). Among 20 factors related to blood pressure control, African Americans also had a higher odds ratio of being nonadherent to their medication, being more functionally illiterate, and having a family member with hypertension compared with whites. Compared with whites, African Americans also were more likely to perceive high blood pressure as serious and to experience the side effect of increased urination compared with whites. Adjusting for these differences reduced the odds ratio of African Americans having adequate blood pressure control to 1.59 (95% confidence interval 1.09-2.29).

CONCLUSIONS

In this sample of hypertensive patients who have good access to health care and medication benefits, African Americans continued to have lower levels of blood pressure control despite considering more than 20 factors related to blood pressure control. Interventions designed to improve medication adherence need to take race into account. Patients' self-reports of failure to take medications provide an opportunity for clinicians to explore reasons for medication nonadherence, thereby improving adherence and potentially blood pressure control.

Authors+Show Affiliations

Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC 27705, USA. hboswort@acpub.duke.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

16431192

Citation

Bosworth, Hayden B., et al. "Racial Differences in Blood Pressure Control: Potential Explanatory Factors." The American Journal of Medicine, vol. 119, no. 1, 2006, pp. 70.e9-15.
Bosworth HB, Dudley T, Olsen MK, et al. Racial differences in blood pressure control: potential explanatory factors. Am J Med. 2006;119(1):70.e9-15.
Bosworth, H. B., Dudley, T., Olsen, M. K., Voils, C. I., Powers, B., Goldstein, M. K., & Oddone, E. Z. (2006). Racial differences in blood pressure control: potential explanatory factors. The American Journal of Medicine, 119(1), e9-15.
Bosworth HB, et al. Racial Differences in Blood Pressure Control: Potential Explanatory Factors. Am J Med. 2006;119(1):70.e9-15. PubMed PMID: 16431192.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial differences in blood pressure control: potential explanatory factors. AU - Bosworth,Hayden B, AU - Dudley,Tara, AU - Olsen,Maren K, AU - Voils,Corrine I, AU - Powers,Benjamin, AU - Goldstein,Mary K, AU - Oddone,Eugene Z, PY - 2005/05/09/received PY - 2005/08/12/revised PY - 2005/08/12/accepted PY - 2006/1/25/pubmed PY - 2006/3/7/medline PY - 2006/1/25/entrez SP - 70.e9 EP - 15 JF - The American journal of medicine JO - Am J Med VL - 119 IS - 1 N2 - PURPOSE: Poor blood pressure control remains a common problem that contributes to significant cardiovascular morbidity and mortality, particularly among African Americans. We explored antihypertensive medication adherence and other factors that may explain racial differences in blood pressure control. METHODS: Baseline data were obtained from the Veteran's Study to Improve The Control of Hypertension, a randomized controlled trial designed to improve blood pressure control. Clinical, demographic, and psychosocial factors relating to blood pressure control were examined. RESULTS: A total of 569 patients who were African American (41%) or white (59%) were enrolled in the study. African Americans were more likely to have inadequate baseline blood pressure control than whites (63% vs 50%; odds ratio = 1.70; 95% confidence interval [CI] 1.20-2.41). Among 20 factors related to blood pressure control, African Americans also had a higher odds ratio of being nonadherent to their medication, being more functionally illiterate, and having a family member with hypertension compared with whites. Compared with whites, African Americans also were more likely to perceive high blood pressure as serious and to experience the side effect of increased urination compared with whites. Adjusting for these differences reduced the odds ratio of African Americans having adequate blood pressure control to 1.59 (95% confidence interval 1.09-2.29). CONCLUSIONS: In this sample of hypertensive patients who have good access to health care and medication benefits, African Americans continued to have lower levels of blood pressure control despite considering more than 20 factors related to blood pressure control. Interventions designed to improve medication adherence need to take race into account. Patients' self-reports of failure to take medications provide an opportunity for clinicians to explore reasons for medication nonadherence, thereby improving adherence and potentially blood pressure control. SN - 1555-7162 UR - https://www.unboundmedicine.com/medline/citation/16431192/Racial_differences_in_blood_pressure_control:_potential_explanatory_factors_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9343(05)00751-5 DB - PRIME DP - Unbound Medicine ER -