AHA: Black Patients Less Likely to Receive Indicated BP Treatment Intensification

MONDAY, Nov. 16, 2020 — Black patients are less likely to receive treatment intensification for blood pressure (BP) control than patients of other races, according to a study presented at the American Heart Association Scientific Sessions 2020, held virtually from Nov. 13 to 17.

Valy Fontil, M.D., from the University of California in San Francisco, and colleagues estimated the likelihood of BP control (BP < 140/90 mm Hg) in Black versus White patients with hypertension and the impact of treatment intensification and missed visits among 6,556 patients (41 percent female; 44 percent Black; mean age, 57.0 years) seen in 12 safety-net clinics from 2015 to 2017.

The researchers found that compared with White patients, Black patients had more missed opportunities for treatment intensification and missed more visits. Black patients remained less likely than White patients to achieve BP control, when adjusting for treatment intensification and missed visits (odds ratio, 0.85). The indirect effect of decreased treatment intensification accounted for 22 percent of the total effect of Black race on BP control, while missed visits accounted for 13 percent. Intensified treatment for blood pressure control was higher in Asian Americans than in other racial groups.

“Our findings should prompt further investigation to determine why Black patients are less likely to have blood pressure therapy increased and why Asian Americans are more likely to be receive more aggressive treatment,” Fontil said in a statement. “These findings also reemphasize the call for adopting treatment protocols and clinical decision supports that can help standardize quality of care for hypertension and perhaps other chronic diseases.”

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