Abstract 17336: Marked Improvement in BP Control Albeit With Recent Decline and Persistence of Racial Disparities in Veterans 2000 to 2014
Background: The VA Electronic Health Record (VAEHR) contributes to effective management and control of hypertension and stores data longitudinally. We examined associations of BP control with age, race, ethnic group, and hypertensive drug treatment.
Methods: In the VAEHR, vital signs were analyzed from 2000 through 2014 and medication records from 2004 to 2014. Patients with elevations >140 systolic or >90 diastolic on three separate days were considered hypertensive. Prescription coverage gaps due to late filling and renewals were examined to compute each patient’s % of days covered per month.
Results: Of 8,813,000 patients followed in the VA system, 3,160,606 were hypertensive. In the total population BP control rates improved from 41.3% in 2000 to 74.6%.in 2010, but gradually declined to 71.3% by 2014. African Americans increased from 40.1% in 2000 to 70.8% in 2010 and declined to 67.4% in 2014 while Whites increased from 42.0% in 2000 to 75.7% in 2010 and fell to 72.4% in 2014. Hispanic control rates were initially 2% worse but are similar to Whites since 2004. While the increase was 5% better in Whites and Hispanics than in African Americans the decline in control rate of 3.3% (p<.0001) starting in 2010 was similar in all racial and ethnic groups (fig.), and in all age groups. For ACEi, alpha blockers, beta blockers, and diuretics, the average coverage per month was 72% for Whites and 67% for African Americans. This 5% disparity did not change after 2010. These gaps can be reduced using “Park a Prescription” to maintain coverage while waiting for drug renewal.
Conclusions: Data from VAEHR over a 14 year period shows a marked improvement over 30% for the first 10 years but a slow decline of 3.3% in the last 4 years. Eliminating drug gaps, which occur in all races, and improving treatment of hypertension should increase BP control rates to and above previous levels.
Figure: Percent of hypertensive patients with controlled BP each month, stratified by race improving each summer.
Author Disclosures: R.D. Fletcher: None. R.L. Amdur: None. R. Kheirbek: None. V. Papademetiou: None. D.D. Maron: None. C. Faselis: None. R.E. Jones: None.
- © 2015 by American Heart Association, Inc.