Cargando…

Racial Disparities in Blood Pressure Control and Treatment Differences in a Medicaid Population, North Carolina, 2005-2006

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,...

Descripción completa

Detalles Bibliográficos
Autores principales: Downie, Diane, Schmid, Dorothee, Plescia, Marcus G., Bostrom, Susan, Yow, Angie, Lawrence, William W., Huston, Sara L., DuBard, C. Annette
Formato: Texto
Lenguaje:English
Publicado: Centers for Disease Control and Prevention 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3103560/
https://www.ncbi.nlm.nih.gov/pubmed/21477495
_version_ 1782204542102798336
author Downie, Diane
Schmid, Dorothee
Plescia, Marcus G.
Bostrom, Susan
Yow, Angie
Lawrence, William W.
Huston, Sara L.
DuBard, C. Annette
author_facet Downie, Diane
Schmid, Dorothee
Plescia, Marcus G.
Bostrom, Susan
Yow, Angie
Lawrence, William W.
Huston, Sara L.
DuBard, C. Annette
author_sort Downie, Diane
collection PubMed
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.
format Text
id pubmed-3103560
institution National Center for Biotechnology Information
language English
publishDate 2011
publisher Centers for Disease Control and Prevention
record_format MEDLINE/PubMed
spelling pubmed-31035602011-06-21 Racial Disparities in Blood Pressure Control and Treatment Differences in a Medicaid Population, North Carolina, 2005-2006 Downie, Diane Schmid, Dorothee Plescia, Marcus G. Bostrom, Susan Yow, Angie Lawrence, William W. Huston, Sara L. DuBard, C. Annette Prev Chronic Dis Original Research 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. Centers for Disease Control and Prevention 2011-04-15 /pmc/articles/PMC3103560/ /pubmed/21477495 Text en https://creativecommons.org/licenses/by/4.0/This is a publication of the U.S. Government. This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.
spellingShingle Original Research
Downie, Diane
Schmid, Dorothee
Plescia, Marcus G.
Bostrom, Susan
Yow, Angie
Lawrence, William W.
Huston, Sara L.
DuBard, C. Annette
Racial Disparities in Blood Pressure Control and Treatment Differences in a Medicaid Population, North Carolina, 2005-2006
title Racial Disparities in Blood Pressure Control and Treatment Differences in a Medicaid Population, North Carolina, 2005-2006
title_full Racial Disparities in Blood Pressure Control and Treatment Differences in a Medicaid Population, North Carolina, 2005-2006
title_fullStr Racial Disparities in Blood Pressure Control and Treatment Differences in a Medicaid Population, North Carolina, 2005-2006
title_full_unstemmed Racial Disparities in Blood Pressure Control and Treatment Differences in a Medicaid Population, North Carolina, 2005-2006
title_short Racial Disparities in Blood Pressure Control and Treatment Differences in a Medicaid Population, North Carolina, 2005-2006
title_sort racial disparities in blood pressure control and treatment differences in a medicaid population, north carolina, 2005-2006
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3103560/
https://www.ncbi.nlm.nih.gov/pubmed/21477495
work_keys_str_mv AT downiediane racialdisparitiesinbloodpressurecontrolandtreatmentdifferencesinamedicaidpopulationnorthcarolina20052006
AT schmiddorothee racialdisparitiesinbloodpressurecontrolandtreatmentdifferencesinamedicaidpopulationnorthcarolina20052006
AT plesciamarcusg racialdisparitiesinbloodpressurecontrolandtreatmentdifferencesinamedicaidpopulationnorthcarolina20052006
AT bostromsusan racialdisparitiesinbloodpressurecontrolandtreatmentdifferencesinamedicaidpopulationnorthcarolina20052006
AT yowangie racialdisparitiesinbloodpressurecontrolandtreatmentdifferencesinamedicaidpopulationnorthcarolina20052006
AT lawrencewilliamw racialdisparitiesinbloodpressurecontrolandtreatmentdifferencesinamedicaidpopulationnorthcarolina20052006
AT hustonsaral racialdisparitiesinbloodpressurecontrolandtreatmentdifferencesinamedicaidpopulationnorthcarolina20052006
AT dubardcannette racialdisparitiesinbloodpressurecontrolandtreatmentdifferencesinamedicaidpopulationnorthcarolina20052006