Leveling Racial Differences of Hypertension

Blood pressure can be higher among African Americans but primary care may be an equalizer

(RxWiki News) Ethnic minorities and those with lower incomes and education tend to have higher blood pressure and less blood pressure control. Primary care could make a difference.

A new study found that when patients had access to a doctor, their blood pressure levels were about the same, regardless of their race or socioeconomic background.

"Work with physicians and pharmacists to get blood pressure under control."

Heart disease remains the leading cause of death in the United States for adults of all races and economic backgrounds. African American adults of both genders are 40 percent more likely to have high blood pressure (hypertension) and 10 percent less likely than their white counterparts to have their blood pressure under control.

Barry Carter, PharmD, with the Department of Pharmacy Practice and Science, College of Pharmacy and professor in the Department of Family Medicine at the University of Iowa in University Heights, and his colleagues collected data on 625 patients who were receiving primary care from a medical office.

All patients had to have high blood pressure and have been treated by their physician but not yet have their blood pressure under control.

Uncontrolled blood pressure is defined as greater than or equal to 140/90 mm Hg for most patients and 130/80 for patients with diabetes or chronic kidney disease (CKD). The first number in a blood pressure reading is systolic, or the pressure on the arteries as the heart contracts. The second number is diastolic, or the pressure as the heart relaxes. About half of the patients had diabetes or CKD.

Over half of the patients (54 percent, or 336 patients) were from racial or ethnic minorities, and 97 percent of these minorities were African American. Patients were an average age of 59 years old, and 60 percent were women.

The average blood pressure among all patients was 149/85. Scientists observed that blood pressure was similar across racial and socioeconomic groups for patients with uncontrolled hypertension in primary care.

Carter told dailyRx News, “[Previous research] would suggest that some racial ethnic minorities—particularly African Americans—have worse blood pressure control or higher levels of blood pressure than Caucasians. We didn’t observe that. We hypothesize that the reason we didn’t see that difference is that everybody in this population of patients had to have access to a doctor—they’re all in a primary care system. They all had to have routine care.”

Participants in this research were part of the Collaboration Among Pharmacists and Physicians to Improve Outcomes Now (CAPTION) trial. This study is designed to determine whether a physician/pharmacist collaborative management intervention for blood pressure should be adopted and implemented in diverse medical offices with high numbers of minorities.

To qualify for the study, each medical office had to employ a clinical pharmacist on staff to provide patient care and/or physician education.

“We’re analyzing results of the main study now,” Carter told dailyRx News. “There’s a lot of literature that shows that team-based care for chronic disease management improves outcomes. Whether care be for blood pressure, diabetes, high cholesterol or anticoagulation, including a pharmacist in the doctor’s office to help care for patients—including the adjustment of medications—improves outcomes.”

Researchers will not have specific recommendations until the final study results are analyzed in about a year, according to Carter.

Carter summed up the results of this study, saying, “If we could get everyone into primary care, maybe we wouldn’t see these racial and economic disparities.”

The study was published in April in The Journal of Clinical Hypertension, the journal of the American Society of Hypertension. Research was supported by the National Heart, Lung, and Blood Institute.

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Review Date: 
April 11, 2013