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Published on: August 1, 2019
Colon cancer screening consultations may identify racial disparity in hypertension diagnosis and management
1George Washington University, Washington, DC, USA. mark425@gwu.edu
Insights
African Americans exhibit higher hypertension rates and poorer blood pressure control compared to whites during colon cancer screening consultations. This highlights critical health disparities requiring urgent attention and improved management strategies.
Area of Science:
- Public Health
- Cardiovascular Health
- Gastroenterology
Background:
- Significant health disparities persist between African Americans and whites in the U.S.
- Colon cancer screening identifies cancer but can also reveal other health issues.
- Hypertension is a major health concern with known racial disparities.
Purpose of the Study:
- To investigate disparities in hypertension prevalence and management between African Americans and whites referred for colon cancer screening.
- To assess if colon cancer screening consultations offer an opportunity to identify and manage hypertension in diverse populations.
Main Methods:
- Retrospective review of medical records for 258 patients (90 African Americans, 168 whites) undergoing colon cancer screening consultations.
- Analysis of hypertension prevalence, diagnosis, and medication management based on race.
Main Results:
- Hypertension was significantly more prevalent in African Americans (80%) compared to whites (25%) (p < 0.005).
- African Americans had poorer blood pressure control and were less likely to be prescribed medication (58%) versus whites (86%) (p = 0.007).
- A substantial proportion of hypertensive African Americans (42%) were never prescribed blood pressure medication.
Conclusions:
- Health disparities in hypertension prevalence and management exist between African Americans and whites, even within the context of colon cancer screening.
- Gastroenterology consultations present a critical opportunity to address undiagnosed or undertreated hypertension in African American patients.
- Increased efforts are needed to mitigate racial health disparities in cardiovascular risk management.
Abstract:
There are significant health disparities between African Americans and whites in the United States. While colon cancer screening aids in decreasing the morbidity and mortality from colon cancer in African Americans, other health risks may also be identified during gastroenterology consultations. This study evaluated whether there is a disparity in the prevalence of hypertension and hypertension management in African Americans compared to whites who are referred for colon cancer screening consultations. The medical records of 258 patients (90 African Americans and 168 whites) were reviewed. Seventy-two of 90 (80%) African-American patients and 42 of 168 (25%) white patients had hypertension. There was a statistically significant difference (p < 0.005) in the rate of hypertension in African Americans compared to whites. Medications were prescribed by their referring physicians for 42 (58%) of the hypertensive African Americans, with 36 noted to have inadequately controlled blood pressure. Thirty (42%) of the hypertensive African-American patients were never prescribed blood pressure medications. Medications were prescribed by their referring physician for 36 (86%) of the hypertensive white patients, with six noted to have inadequately controlled blood pressure. Six (14%) of the hypertensive white patients were never prescribed blood pressure medications. There was a statistically significant difference in the rate of blood pressure control (p = 0.007) between African-American and white patients who were referred for colon cancer screening. Increased efforts are necessary to identify critical health concerns of all patients and to decrease health disparities between African Americans and whites in the United States.
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