Blood pressure care in U.S. improving, but disparities remain
Doctors are treating blacks nearly as often as whites for high blood pressure, new research shows, but blacks are still less likely to have the condition under control.
(Reuters Health) – Treatment of high blood pressure is improving in the United States, but a new study suggests white people are seeing more improvements than black or Hispanic people.
Blacks and Hispanics were less likely to have their blood pressure under control, compared to whites, researchers found. Hispanics were also less likely than whites to be treated for the condition.
The new study shows public health efforts to improve blood pressure control are working, but “there are still disparities that still affect minorities,” said senior author Dr. Edgar Argulian, of Mt. Sinai St. Luke’s Hospital in New York City.
“It probably means we need to tweak those efforts,” he told Reuters Health.
The American Heart Association (AHA) recommends keeping systolic blood pressure (the top number of a reading) below 120 millimeters of mercury (mmHg). Diastolic blood pressure (the bottom number) should be below 80 mmHg.
High blood pressure – known as hypertension – can lead to stroke, heart problems, kidney disease and other health issues, according to the AHA. Doctors usually start prescribing medicine to lower blood pressure when a person’s readings are consistently over 140/90 mmHG.
For the new study, the researchers analyzed data collected from 8,796 U.S. adults with high blood pressure between 2003 and 2012 as part of the National Health and Nutrition Examination Survey.
Blood pressure treatment and control increased during that time period, the researchers write in Circulation: Cardiovascular Quality and Outcomes.
Treatment rates increased from about 66 percent in 2003-2004 to about 77 percent in 2010-2012. The proportion of people who got their blood pressure under control increased from 33 percent to 45 percent over the same period.
White people tended to do better on a variety of measures, however.
About 74 percent of whites, 71 percent of blacks and 61 percent of Hispanics were being treated for their high blood pressure over the course of the study, the researchers found.
All three groups experienced substantial improvement in hypertension control over the course of the study. But while roughly 43 percent of whites had their hypertension under control during the study period, only about 37 percent of blacks and about 31 percent of Hispanics could say the same.
Doctors are treating blacks nearly as often as whites for high blood pressure, the researchers note, but blacks are still less likely to have the condition under control.
Black people are particularly predisposed to high blood pressure and more aggressive forms of the condition, said Argulian.
Unlike blacks, Hispanics were not treated as aggressively as whites for high blood pressure. They were also less likely to have their condition under control.
“There is no biological evidence to suggest that Hispanics are more vulnerable to loss of blood pressure control,” lead author Dr. Anna Gu, of St. John’s University in New York, told Reuters Health.
For Hispanics, factors like access to health insurance and language barriers may be obstacles to getting appropriate care, Gu said.
“One of the things we should get out of this study is what a bad job we’re doing controlling blood pressure across the board,” said Dr. Leslie Cho, who directs the Cleveland Clinic’s Women’s Cardiovascular Center in Ohio.
Doctors can be better at providing the best proven treatments for individual patients, said Cho, who was not involved with the new study.
For example, she told Reuters Health, high blood pressure among black people responds well to drugs known as calcium channel blockers and diuretics.
People should be encouraged to monitor their blood pressure at home, she added.
Argulian said treating hypertension is a complex issue that goes beyond merely giving patients pills to take. Blood pressure control needs to take into account many lifestyle factors like weight and diet, but also social factors like insurance access and ability to get and take medications, he said.
SOURCE: bit.ly/2iSgw5U Circulation: Cardiovascular Quality and Outcomes, online January 17, 2017.