Details:

Alternative Title:
Prev Chronic Dis
Personal Author:
Downie, Diane ; Schmid, Dorothee ; Plescia, Marcus G. ; Bostrom, Susan ; Yow, Angie ; ... More +
Downie, Diane ; Schmid, Dorothee ; Plescia, Marcus G. ; Bostrom, Susan ; Yow, Angie ; Lawrence, William W. ; Huston, Sara L. ; DuBard, C. Annette Less -
Description:
Introduction

Racial disparities in prevalence and control of high blood pressure are well-documented. We studied blood pressure control and interventions received during the course of a year in a sample of black and white Medicaid recipients with high blood pressure and examined patient, provider, and treatment characteristics as potential explanatory factors for racial disparities in blood pressure control.

Methods

We retrospectively reviewed the charts of 2,078 black and 1,436 white North Carolina Medicaid recipients who had high blood pressure managed in primary care practices from July 2005 through June 2006. Documented provider responses to high blood pressure during office visits during the prior year were reviewed.

Results

Blacks were less likely than whites to have blood pressure at goal (43.6% compared with 50.9%, P = .001). Blacks above goal were more likely than whites above goal to have been prescribed 4 or more antihypertensive drug classes (24.7% compared with 13.4%, P < .001); to have had medication adjusted during the prior year (46.7% compared with 40.4%, P = .02); and to have a documented provider response to high blood pressure during office visits (35.7% compared with 30.0% of visits, P = .02). Many blacks (28.0%) and whites (34.3%) with blood pressure above goal had fewer than 2 antihypertensive drug classes prescribed.

Conclusion

In this population with Medicaid coverage and access to primary care, blacks were less likely than whites to have their blood pressure controlled. Blacks received more frequent intervention and had greater use of combination antihypertensive therapy. Care patterns observed in the usual management of high blood pressure were not sufficient to achieve treatment goals or eliminate disparities.


Subject:
[+]
Adult
Aged
Antihypertensive Agents
Blacks
Blood Pressure
Female
Healthcare Disparities
Health Services Research
Humans
Hypertension
Male
Medicaid
Middle Aged
Retrospective Studies
Whites
Young Adult

Source:
Prev Chronic Dis. 2011; 8(3).
Document Type:
Journal Article
Place as Subject:
North Carolina
Collection(s):
Preventing Chronic Disease
Main Document Checksum:
[+]
urn:sha256:5d164a75cb2b142d7a7be37bac185b38724e32d2dd7a4feeae0b32a78f53bc84
File Type:

Supporting Files

• 	license.txt	txt
  	PCD83A55.nxml	txt

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