Abstract 15229: Racial Disparity in Blood Pressure Control in VA Patients from 2000 to 2011
The VA Electronic Health Record with reminders effectively manages hypertension and stores data longitudinally. Vital signs from the entire VA were analyzed between 2000 and 2011. Of 7,361,848 patients with 274,162,609 BP measurements; 4,055,558 had elevations >140 systolic or >90 diastolic on three separate days. Analysis was made for age, race, treatment and BMI. Control for Blacks improved from 49.8 in 2000 to 72.5 in 2011, and Whites from 50.6 to 77.0 respectively (Fig. 1). Black/White difference was small when both groups were poorly controlled (2000 - 2001), but as treatment improved, Blacks consistently were less well controlled than Whites. BMI for hypertensive Blacks and Whites remained steady at 29.5 until 2006, then increasing for both, reaching 30.1 in 2011. This increase may explain why controlling hypertension becoming more difficult in 2006. Normotensive Blacks had a BMI of 25.5 in 2000 rising to 27.7 in 2011, while Whites increased from 26.6 to 27.9 respectively (Fig. 2). Drug data became available starting in 2004. Both Blacks and Whites received the same number of anti-hypertensive medicine classes (2.7 ± 1.4, p=0.21). Medicine coverage, where the number of daily doses were compared with frequency of refills, showed no racial difference (81.0% + 16%, p=0.64).
Conclusion: Blacks and Whites both improved hypertensive control over 11 years with Blacks consistently 5% less well controlled than Whites. The reason for this disparity cannot be explained by differences in BMI, number of medicine classes or less coverage. More intensive treatment, with improved weight control, may be required if Blacks are to achieve BP control equal to Whites.
Author Disclosures: R.D. Fletcher: None. R.L. Amdur: None. R. Kheirbek: None. V. Papademetriou: None. A. Ahmed: None. F. Alemi: None. D. Maron: None. C. Faselis: None. R.E. Jones: None.
- © 2014 by American Heart Association, Inc.