Hypertension control poorer in blacks than whites

By Will Boggs, MD

NEW YORK (Reuters Health) - Better compliance with treatment could improve racial differences in how well patients keep high blood pressure under control, VA researchers report.

"Nonadherence to a hypertension treatment regimen is a significant barrier to achieving hypertension treatment goals and is quite prevalent," Dr. Hayden B. Bosworth from the Durham Veterans Affairs Medical Center, North Carolina, told Reuters Health.

Bosworth and colleagues studied 569 veterans -- 41 percent black and 59 percent white -- in order to identify the social, economic, and physical factors that may explain racial differences in blood pressure control.

African-Americans were 70 percent more likely to have inadequate blood pressure control compared with whites, the investigators report in The American Journal of Medicine.

Also, African-Americans were 81 percent more likely to not stick to their medication regimen.

After adjustment for more than 20 potential factors, African-Americans were still 59 percent more likely than whites to have poor blood pressure control, the team found.

Being patients in the VA medical system, blacks and whites had comparable access to good medical care. "Our results suggest that economic barriers and access to care are not the only contributors to racial differences in blood pressure control," the researchers conclude.

"Simply asking patients, 'Are you having problems with your hypertension treatment regimen or can you tell me how you treat your hypertension,' can provide an opportunity for physicians to explore reasons for nonadherence, thereby improving adherence and blood pressure control," Bosworth commented.

He added that his group is currently engaged in three research projects designed to clarify and eliminate racial disparities in blood pressure control.

SOURCE: American Journal of Medicine, January 2006.