Understanding racial disparities in hypertension control: intensity of hypertension medication treatment in the REGARDS study.

Academic Article

Abstract

  • OBJECTIVES: African Americans (AA) suffer excess hypertension-related health outcomes and their blood pressures (BPs) are widely reported to be less controlled than European Americans (EA). Intensity of hypertension treatment may play a role. We examined whether AA with treated hypertension received less-intense medication regimens than EA, as reflected in the number of antihypertensive medication classes. DESIGN: Cross-sectional observation of baseline information from the REasons for Geographic And Racial Differences in Stroke cohort. Participants were recruited by telephone in 2003-2005, completed a telephone survey, and had BP measured and medications recorded during an in-home visit. The study's outcome was the number of classes of antihypertensive medications. SETTING: U.S. national cohort study with oversampling from high stroke mortality regions. Participants were self-identified AA or EA, > or =45 years old, living in the community, and balanced on AA race and sex by design. PARTICIPANTS: 8960 individuals with treated hypertension. RESULTS: Mean age was 68.0 +/- 8.6 years. AA were poorer and less educated than EA, and had worse BP control (63.5% BP < 140/ 90 mm Hg for AA, 74.0% for EA, P < .01), yet they were on more classes of BP medication (24.1% on > or =3 classes, vs. 16.9%, P < .01). AA were taking an average of 0.138 more antihypertensive medication classes than otherwise similar EA (P < .01). More intense treatment persisted across all age, sex, education, income and BP groups. CONCLUSIONS: AA were more intensely treated for hypertension than EA. Further study to identify action strategies to eliminate racial differences in hypertension outcomes is warranted.
  • Published In

    Keywords

  • African Americans, Aged, Cross-Sectional Studies, Female, Healthcare Disparities, House Calls, Humans, Hypertension, Male, Middle Aged, Practice Patterns, Physicians', United States
  • Author List

  • Safford MM; Halanych JH; Lewis CE; Levine D; Houser S; Howard G
  • Start Page

  • 421
  • End Page

  • 426
  • Volume

  • 17
  • Issue

  • 3