Some Lack Access to Hypertension Rx

Hypertension in African American patients not being treated with diuretics despite recommendations

/ Author:  / Reviewed by: Chris Galloway, M.D.

(RxWiki News) African Americans face a higher risk of hypertension, or high blood pressure. Unfortunately, they aren't as likely as others to be prescribed the best medicine to treat the condition.

Not controlling blood pressure can increase the risk of stroke and heart problems.

A recent study looked at a sample of African American patients with uncontrolled hypertension. Results found that only 46 percent of patients were prescribed a diuretic to treat hypertension.

The American Heart Association recommends the use of diuretics to treat hypertension. This study found that despite the recommendations, African Americans were often not being prescribed diuretics. 

"See a doctor regularly to have your blood pressure checked"

Linda Gerber, PhD, of Department of Public Health at Weill Cornell Medical College in New York, and colleagues set out to examine how often African Americans with uncontrolled hypertension were prescribed diuretics.

The study included 658 African American patients ages 21 to 80. Researchers conducted interviews with patients to get information about their prescription medications. During the interviews, patients had their diastolic and systolic blood pressure measured.

Diastolic blood pressure is the pressure in the arteries when the heart rests between beats. If the pressure is over 90, it signals hypertension. Systolic blood pressure is the pressure in the arteries when the heart beats. If the pressure is 140 or higher, it signals hypertension.

Results showed that 5.5 percent of the patients were not prescribed any medications at all to treat hypertension. Diuretics were prescribed to 46 percent of patients. 

If the patient was not prescribed diuretics, they also had fewer medications prescribed to treat hypertension. These patients had a higher mean diastolic blood pressure of 89.2. In comparison, patients on diuretics had a mean diastolic blood pressure of 85.5.

Also, of the patients not taking a diuretic, 57.6 percent had a systolic blood pressure of 160 or above, compared to 49 percent of the patients taking diuretics.

"In this sample of African American patients with uncontrolled hypertension, despite the wide publicizing of the recommendations for use of diuretics, a majority are still not receiving a diuretic," the authors commented.

The authors noted several limitations of their study. First, the patients were from a single urban Medicaid/Medicare certified home health organization. As such, the ability to generalize results may be limited. Second, information and three blood pressure readings were collected during only one interview. Lastly, the dose of the diuretic was not collected.

This study, titled "Diuretic Use in Black Patients With Uncontrolled Hypertension," was published in the Journal of Hypertension. It was funded by the National Heart, Lung and Blood Institute. Dr. Gerber and colleagues disclosed no conflicts of interest.

Reviewed by: 
Review Date: 
January 24, 2013
Last Updated:
January 26, 2013