--- title: "Disparities in blood pressure control. | Sutter Health" description: "Potential disparities, particularly among diabetic individuals and those of minority race/ethnicity, were found with regard to BP control and the agents used to treat hypertension." url: "https://www.sutterhealth.org/research/publications/disparities-in-blood-pressure-control-1055312715" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Disparities in blood pressure control. # Disparities in blood pressure control within a community-based provider network: an exploratory analysis. Romanelli RJ1, Schiro TA, Jukes T, Wong KS, & Ishisaka DY. _Ann Pharmacother. 45(12):1473-82. doi: 10.1345/aph.1Q523. Epub 2011 Dec 6._ 2011-12-01 ## Abstract #### BACKGROUND: Despite treatment for hypertension, blood pressure (BP) remains uncontrolled in many individuals. Identification of patterns in BP control may inform strategies to improve treatment and optimize health outcomes. #### OBJECTIVE: To examine patterns in BP control among individuals receiving antihypertensive treatment in a diverse, community-based provider network. #### METHODS: In this retrospective exploratory analysis, a total of 51,772 hypertensive subjects were identified in the electronic medical record between January 1, 2007, and June 30, 2010, who were aged 18 years or older, with 2 or more claims for antihypertensive medication, documented race/ethnicity, and 1 or more documented BP readings. #### RESULTS: On the basis of Joint National Committee VII guidelines, 76.4% of nondiabetic patients had their BP controlled with treatment (<140/90 mm Hg) and 52.3% of those with diabetes had their BP controlled with treatment (<130/80 mm Hg). The overall rate of BP control was 71.4%. Factors associated with controlled BP included younger age, lower disease burden, better medication adherence, fewer concurrent prescriptions, lower prescription copayments, and living in a region with a higher median household income. Furthermore, when adjusting for age, sex, and disease burden, black (OR 0.68; 95% CI 0.62 to 0.75; p < 0.001), Hispanic (OR 0.80; 95% CI 0.74 to 0.86; p < 0.001), and other race/ethnic group (OR 0.81; 95% CI 0.70 to 0.94; p = 0.005) individuals were less likely than white individuals to have their treated BP controlled. Among nondiabetic hypertensive subjects with controlled BP, the most frequently prescribed therapy was a β-blocker or an angiotensin-converting enzyme (ACE) inhibitor across race/ethnicities; however, those who were black were most frequently prescribed a diuretic or calcium channel blocker. Among diabetic patients with controlled BP, the most frequently prescribed therapy was an ACE inhibitor, regardless of race/ethnicity. #### CONCLUSIONS: Potential disparities, particularly among diabetic individuals and those of minority race/ethnicity, were found with regard to BP control and the agents used to treat hypertension. Future studies should address these disparities by designing interventions to improve the treatment of hypertension in high-risk populations. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/22147145) ## Research topics - [Cardiovascular Diseases](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Cardiovascular+Diseases%5C%22%22) - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Health Disparities](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Disparities%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Dyslipidemia in special ethnic populations.](https://www.sutterhealth.org/research/publications/dyslipidemia-special-ethnic-populations-1055312482) Pu J, Romanelli R, Zhao B, Azar KM, Hastings KG, Nimbal V, Fortmann SP, Palaniappan LP. Endocrinol Metab Clin North Am. 45(1):205-16. doi: 10.1016/j.ecl.2015.09.013 2016 Mar 01 - Publication ### [Disparities in adherence to and persistence with antihypertensive regimens: an exploratory analysis from a community-based provider network.](https://www.sutterhealth.org/research/publications/disparities-in-adherence-to-anti-htn-regimens-1055312629) Ishisaka DY, Jukes T, Romanelli RJ, Wong KS, Schiro TA. J Am Soc Hypertens. 6(3):201-9. doi: 10.1016/j.jash.2012.02.004. 2012 May 01 - Publication ### [Case management to reduce risk of cardiovascular disease in a county health care system.](https://www.sutterhealth.org/research/publications/case-mgmt-reduce-cvd-risk-county-health-system-1055312926) Ma J, Berra K, Haskell WL, Klieman L, Hyde S, Smith MW, Xiao L, Stafford RS. Arch Intern Med. 2009;169(21):1988-1995. doi:10.1001/archinternmed.2009.381. 2009 Nov 23 - Publication ### [The effectiveness of two community-based weight loss strategies among obese, low-income US Latinos.](https://www.sutterhealth.org/research/publications/community-wt-loss-programs-for-obese-latinos-1055312788) Rosas LG, Thiyagarajan S, Goldstein BA, Drieling RL, Romero PP, Ma J, Yank V, Stafford RS. J Acad Nutr Diet. pii: S2212-2672(14)01589-5. doi: 10.1016/j.jand.2014.10.020. \[Epub ahead of print\] 2015 Jan 08 - Publication ### [Profiles of sociodemographic, behavioral, clinical and psychosocial characteristics among primary care patients with comorbid obesity and depression.](https://www.sutterhealth.org/research/publications/characteristics-primary-care-pts-with-obesity-depression-1055312347) Ma J, Xiao L, Lv N, Rosas LG, Lewis MA, Goldhaber-Fiebert JD, Venditti EM, Snowden MB, Lesser L, Ward E. Prev Med Rep. 8:42-50. doi: 10.1016/j.pmedr.2017.07.010. eCollection 2017 Dec. 2017 Aug 05 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/disparities-in-blood-pressure-control-1055312715#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Disparities in blood pressure control."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/disparities-in-blood-pressure-control-1055312715#medicalscholarlyarticle","name":"Disparities in blood pressure control within a community-based provider network: an exploratory analysis.","headline":"Disparities in blood pressure control.","abstract":"BACKGROUND: Despite treatment for hypertension, blood pressure (BP) remains uncontrolled in many individuals. Identification of patterns in BP control may inform strategies to improve treatment and optimize health outcomes. OBJECTIVE: To examine patterns in BP control among individuals receiving antihypertensive treatment in a diverse, community-based provider network. METHODS: In this retrospective exploratory analysis, a total of 51,772 hypertensive subjects were identified in the electronic medical record between January 1, 2007, and June 30, 2010, who were aged 18 years or older, with 2 or more claims for antihypertensive medication, documented race/ethnicity, and 1 or more documented BP readings. RESULTS: On the basis of Joint National Committee VII guidelines, 76.4% of nondiabetic patients had their BP controlled with treatment (\u003c140/90 mm Hg) and 52.3% of those with diabetes had their BP controlled with treatment (\u003c130/80 mm Hg). The overall rate of BP control was 71.4%. Factors associated with controlled BP included younger age, lower disease burden, better medication adherence, fewer concurrent prescriptions, lower prescription copayments, and living in a region with a higher median household income. Furthermore, when adjusting for age, sex, and disease burden, black (OR 0.68; 95% CI 0.62 to 0.75; p \u003c 0.001), Hispanic (OR 0.80; 95% CI 0.74 to 0.86; p \u003c 0.001), and other race/ethnic group (OR 0.81; 95% CI 0.70 to 0.94; p = 0.005) individuals were less likely than white individuals to have their treated BP controlled. Among nondiabetic hypertensive subjects with controlled BP, the most frequently prescribed therapy was a β-blocker or an angiotensin-converting enzyme (ACE) inhibitor across race/ethnicities; however, those who were black were most frequently prescribed a diuretic or calcium channel blocker. Among diabetic patients with controlled BP, the most frequently prescribed therapy was an ACE inhibitor, regardless of race/ethnicity. CONCLUSIONS: Potential disparities, particularly among diabetic individuals and those of minority race/ethnicity, were found with regard to BP control and the agents used to treat hypertension. Future studies should address these disparities by designing interventions to improve the treatment of hypertension in high-risk populations.","description":"Potential disparities, particularly among diabetic individuals and those of minority race/ethnicity, were found with regard to BP control and the agents used to treat hypertension.","keywords":["Cardiovascular Diseases","Disease Management","Health Disparities"],"datePublished":"2011-12-01","url":"https://www.sutterhealth.org/research/publications/disparities-in-blood-pressure-control-1055312715","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"22147145"},{"@type":"PropertyValue","propertyID":"DOI","value":"10.1345/aph.1Q523"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/22147145/","https://doi.org/10.1345/aph.1Q523"],"isPartOf":{"@type":"Periodical","name":"Ann Pharmacother"},"author":[{"@type":"Person","name":"Romanelli RJ"},{"@type":"Person","name":"Schiro TA"},{"@type":"Person","name":"Jukes T"},{"@type":"Person","name":"Wong KS"},{"@type":"Person","name":"Ishisaka DY"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Cardiovascular Diseases","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Cardiovascular+Diseases%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Disease Management","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Disease+Management%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Disparities","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Disparities%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/disparities-in-blood-pressure-control-1055312715","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/disparities-in-blood-pressure-control-1055312715#breadcrumblist"}}} ```