Key result
In a predominantly African American inner-city clinic population, 50.9% of hypertensive patients achieved goal blood pressure, with older age and diabetes associated with poorer control.
Cross-Sectional (n=416)
Yes
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In an inner-city African American population, BP control was achieved in 51% of patients, but the predominant use of ACE inhibitors and underutilization of CCBs and diuretics in diabetics highlight potential gaps in guideline-concordant care.
African Americans bear a greater burden of hypertension. Understanding prevailing epidemiologic patterns can facilitate the implementation and successful outcome of community programs. The authors assessed practice patterns of antihypertensive drug utilization and blood pressure (BP) control in a predominantly African American population in Brooklyn, NY, from January 1 to January 31, 2008. A total of 416 (53.1%) had hypertension, with a mean age of 61 years, and 267 (64%) were women. In general, 212 (50.9%) were at goal BP and 59.9% of those at goal were taking at least 2 drugs. Patient age correlated with the number of drugs used (r=0.14; P=.004). Patients taking beta-blockers and calcium channel blockers were older: 63.6 vs 60.1 years (P=.01) and 62.7 vs 60.3 years (P=.07), respectively. The pattern of antihypertensive use was as follows: angiotensin-converting enzyme inhibitors, 194 (46.6%); calcium channel blockers, 162 (38.9%); diuretics, 162 (38.9%); beta-blockers, 133(32%); and angiotensin receptor blockers, 93 (22.4%). The findings of age associated with the class of medications used and a predominance of angiotensin-converting enzyme inhibitors usage highlight possible gaps in appropriateness of antihypertensive therapy. The application of age-appropriate race-based antihypertensive therapy might improve BP control rates. These results strengthen arguments for investing in community-based programs to overcome possible provider-related and local health system barriers to achieving BP control goals.
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Odigie‐Okon et al. (2010) conducted a cross-sectional in Hypertension (n=416). Antihypertensive therapy was evaluated on Blood pressure control according to JNC 7 guidelines. In a predominantly African American inner-city clinic population, 50.9% of hypertensive patients achieved goal blood pressure, with older age and diabetes associated with poorer control.
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