Hypertension: Journal of the American Heart Association Rapid Access Reports: Hispanics' Hypertension Better Controlled With Equal Access to Care
DALLAS, Sept. 12 -- With equal access to medical care and medication,Hispanic men and women have as good or greater chance as non-Hispanics ofcontrolling their high blood pressure, researchers reported in Hypertension:Journal of the American Heart Association.
"Poor blood pressure control in Hispanics is not due to biological factorsassociated with race or ethnicity," said Karen L. Margolis, M.D., M.P.H.,senior clinical investigator at the HealthPartners Research Foundation inMinneapolis, Minn. "If treated aggressively with a good medication regimen,Hispanics have an equal chance of controlling blood pressure."
Population-based research has shown that hypertension awareness, treatmentand control is lower among Hispanics compared to non-Hispanic whites andblacks.
When researchers studied blood pressure control in Hispanics as part ofthe ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent HeartAttack Trial), they found that Hispanics responded as well or better than non-Hispanics.
Hispanics were less likely to have their blood pressure controlled whenentering the study despite a similar proportion being on blood pressuremedication. But at the four-year follow-up, blood pressure was controlled in72 percent of Hispanic whites and 69 percent of Hispanic blacks compared to 67percent of non-Hispanic whites and 59 percent of non-Hispanic blacks.
At two years, Hispanic whites had 20 percent greater odds of achievingblood pressure control compared to non-Hispanic whites, after researchersadjusted for demographic differences and co-morbidities such as diabetes,smoking and existing cardiovascular disease. Hispanic blacks had similar oddsof achieving blood pressure control; however, non-Hispanic blacks had 27percent lower odds of achieving blood pressure control at two years.
When participants from Puerto Rico and the Virgin Islands were excluded ina separate analysis at two years, blood pressure control was equivalent inHispanics and non-Hispanic whites enrolled at sites in the mainland U.S. andCanada.
The ALLHAT study included 32,642 Hispanic whites, Hispanic blacks, non-Hispanic whites and non-Hispanic blacks in a randomized practice-based trialin 623 sites in the United States, Canada, Puerto Rico and the U.S. VirginIslands. Researchers conducted ALLHAT to determine what type of drug was moreeffective in preventing the cardiovascular complications of hypertension inhigh-risk men and women. Participants were seen every three months the firstyear and every four months thereafter. All had hypertension and at least oneadditional risk factor for coronary heart disease. Participants were treatedwith one of three initial drugs, and then additional therapy if thehypertension was not controlled. "The goal was for participants to reach ablood pressure less than 140/90 mmHg."
"This was the first study to compare blood pressure control in these fourrace-ethnicity categories," said Margolis, who is also an associate professorof medicine at the University of Minnesota.
Hispanic ALLHAT participants were more likely than non-Hispanicparticipants to have higher, uncontrolled blood pressure despite treatment atthe time of enrollment, she said.
Margolis stressed the importance of controlling blood pressure inHispanics, the largest ethnic minority in the United States at 14 percent ofthe population. "Blood pressure was controlled in more than two-thirds ofHispanic ALLHAT par
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