Details:

Alternative Title:
Circ Cardiovasc Qual Outcomes
Publisher's site:
http://dx.doi.org/10.1161/CIRCOUTCOMES.114.000950
Personal Author:
Yi, Stella S. ; Tabaei, Bahman P. ; Angell, Sonia Y. ; Rapin, Anne ; Buck, Michael D ; ... More +
Yi, Stella S. ; Tabaei, Bahman P. ; Angell, Sonia Y. ; Rapin, Anne ; Buck, Michael D ; Pagano, William G. ; Maselli, Frank J. ; Simmons, Alvaro ; Chamany, Shadi Less -
Description:
Background

Hypertension is a leading risk factor for cardiovascular disease. While control rates have improved over time, racial/ethnic disparities in hypertension control persist. Self-blood pressure monitoring (SBPM), by itself, has been shown to be an effective tool in predominantly white populations, but less studied in minority, urban communities. These types of minimally intensive approaches are important to test in all populations, especially those experiencing related health disparities, for broad implementation with limited resources.

Methods and Results

The New York City Health Department in partnership with community clinic networks implemented a randomized clinical trial (n=900, 450 per arm) to investigate the effectiveness of SBPM in medically underserved, and largely black and Hispanic participants. Intervention participants received a home blood pressure (BP) monitor and training on use, while control participants received usual care. After 9 months, systolic BP decreased (intervention: 14.7 mm Hg, control: 14.1 mm Hg; p=0.70). Similar results were observed when incorporating longitudinal data and calculating a mean slope over time. Control was achieved in 38.9% of intervention and 39.1% of control participants at the end of follow-up; the time-to-event experience of achieving BP control in the intervention vs. control were not different from each other (logrank p-value=0.91).

Conclusions

SBPM was not shown to improve control over usual care in this largely minority, urban population. The patient population in this study, which included a high proportion of Hispanics and uninsured persons is understudied. Results indicate these groups may have additional meaningful barriers to achieving BP control beyond access to the monitor itself.


Subject:
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African Americans
Aged
Antihypertensive Agents
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Electronic Health Records
Female
Health Knowledge, Attitudes, Practice
Hispanic Americans
Humans
Hypertension
Male
Medically Uninsured
Middle Aged
Patient Education As Topic
Predictive Value Of Tests
Risk Factors
Risk Reduction Behavior
Time Factors
Treatment Outcome
Urban Health
Vulnerable Populations

Source:
Circ Cardiovasc Qual Outcomes. 8(2):138-145
Pubmed ID:
25737487
Pubmed Central ID:
PMC4366280
Document Type:
Journal Article
Funding:
P60 MD000538/MD/NIMHD NIH HHS/United States ; U48 DP005008/DP/NCCDPHP CDC HHS/United States ; U54 MD000538/MD/NIMHD NIH HHS/United States ; 2P60MD000538-10/MD/NIMHD NIH HHS/United States
P60 MD000538/MD/NIMHD NIH HHS/United States ; U48 DP005008/DP/NCCDPHP CDC HHS/United States ; U54 MD000538/MD/NIMHD NIH HHS/United States ; 2P60MD000538-10/MD/NIMHD NIH HHS/United States Less -
Place as Subject:
New York City, NY
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:d95d22b7379ccfb2c51223dbb43763e91474839e454b0b1527a7f36beedf3506
File Type:

Supporting Files

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  	NIHMS661485-supplement-smartform.pdf	pdf

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