Abstract 14756: Controlling Hypertension in Blacks - A VA 10 Year Multicenter Analysis
Background: Blacks have been considered more difficult to control than Whites, so we reviewed their care in 15 VA hospitals over a 10 year period (9/2000 to 8/2010).
Methods: There were 582,881 hypertensives in the study. Of those identified as by race, 25.1% were Black, and 52.3% were White. BP control included use of electronic medical records with automated reminders, medical regimen adjustments, and frequent visits to both specialty and nurse run clinics.
Results: All 15 hospitals improved their control of blood pressure significantly in the 10 years. On average, Blacks had improved from 47.1% returned to normal to 71.7%, and Whites 50.6% to 76.6%. Blacks still lagged behind Whites. Blacks were controlled an average of 65.8% (range 66-78%) and Whites 77.3% (range 71-83%). High rates of control in some hospitals allow analysis of best practice to improve control of Blacks equal to Whites. A sub study of 2 of the 15 hospitals, here labeled hospital AA and BB, showed Blacks to be under therapy as much as Whites, but showed them to be on more than 2 antihypertensive classes. Blacks were on diuretics more frequently (AA and BB Blacks 70.3%,71.8% vs. White 56.6%, 57.6%, p > 0. 001), had a higher use of Hydralazine (AA and BB Blacks 8.9%, 8.5% vs. White 3.6%, 2.9%, p > 0.001), and Clonidine (AA and BB Blacks 10.9%,15.2% vs. White 5.2%,5.7%, p > 0.001).
Conclusions: Both Black and White patients can achieve high rates of BP control,but Blacks still lag behind Whites. Our goal is to improve control of BP in both races and have control in Blacks equal to Whites.
- © 2012 by American Heart Association, Inc.