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Blood pressure control inequality linked to deaths among blacks

Published on November 10, 2008 at 10:36 PM · No Comments

Racial disparity in the control of hypertension contributes to the deaths of almost 8,000 black men and women in the United States annually, according to a first-of-its-kind study published today in the Annals of Family Medicine by University of Rochester Medical Center researchers.

The researchers concluded that the deaths could be avoided or postponed if blacks had their hypertension, or high blood pressure, controlled to the same level as whites.

"Disparity in the control of blood pressure is one of the most important, if not the most important, contributor to racial disparity in cardiovascular mortality, and probably overall mortality," said Kevin Fiscella, M.D., M.P.H., lead author of the article and associate professor of family medicine and of community and preventive medicine at the Medical Center.

"If we as clinicians are going to reduce cardiovascular and stroke-related deaths, we need to pay attention to all the barriers to improving blood pressure control, particularly for minority patients" Fiscella said.

Although not clearly known, the likely causes of the racial disparity include differences in access to care, clinician management and communication, hypertension severity, and patient adherence.

"There is evidence from previous studies that access barriers and financial and interpersonal communication barriers affect the ability of black patients to get medical care or to take their medication as prescribed," Fiscella said.

Fiscella and Kathleen Holt, Ph.D., adjunct professor of community and preventive medicine at the Medical Center, are authors of the articles, which is the first effort to quantify the toll of racial disparity in blood pressure control. The article is part of a package of articles on racial disparity in the Annals of Family Medicine that is accompanied by editorials from former U.S. Surgeon General David Satcher, M.D., Ph.D., and Crystal Wile Cené, M.D., M.P.H., and Lisa A. Cooper, M.D., M.P.H. They call on clinicians, researchers, health care administrators, health care planners and policy makers to work together to gain a better understanding of the barriers faced by ethnic minorities.

Hypertension is a precursor to cardiovascular disease, which is the leading cause of death in the United States and which occurs at the highest rate among black Americans.

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