Abstract 16017: Blood Pressure Control in All VA Patients From 2000 to 2011 With Analysis of Racial Disparity and Body Mass Index for Further Improvements
The VA Electronic Health Record with reminders effectively manages hypertension. All vital signs from the entire VA were analyzed between 2000 and 2011. Of 8,868,500 patients with 241,456,960 BP measurements; 4,353,382 had elevations >140 systolic or >90 diastolic on three separate days. Analysis was made for age, race, treatment, and Body Mass Index (BMI). Control improved from 47% in 2000 to 75% in 2011. Control is more effective in the summer. Race and age was analyzed by dividing White and Black patients into those patients < 65 y/o and ≥ 65 y/o. Over time, the young and old in each race are equally controlled, but Blacks lag behind Whites for control of hypertension from 2002 to 2011. Analyzing the groups by quartile from best Black control to worse, there was no difference between the four groups for Blacks on ≥ 3 antihypertensive medications (46%} or on no antihypertensive medications (10%). In each quartile Whites were better controlled with 20% fewer on ≥ 3 or more classes of medications and 40% more on no medications. The best controlled Black quartile (75-84%) had the lowest BMI (28.8-29.6). Blacks had a higher BMI with less BP control. Blacks who were never hypertensive had an even lower average BMI (27.4-28.7). Similarly, the best White quartile for control of BP also had the lowest BMI.
Conclusions: Blacks and Whites showed significant improvement over the course of the 11 year study. Age does not affect control of blood pressure once controlled for by Race after 2005. Blacks remained less controlled even though they were treated more aggressively than Whites. Best control in both Blacks and Whites appears related to lower BMI. Controlling weight may improve all hypertensive patients.
- © 2013 by American Heart Association, Inc.