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Trust in physicians and blood pressure control in blacks and whites being treated for hypertension in the REGARDS

Raegan W Durant1, Leslie A McClure, Jewell H Halanych

  • 1Division of Preventive Medicine; University of Alabama at Birmingham, Birmingham, AL 35294, USA. rdurant@mail.dopm.uab.edu

Ethnicity & Disease
|September 11, 2010
PubMed

Insights

Physician trust did not explain racial disparities in hypertension control. Black race and poor medication adherence were linked to uncontrolled blood pressure, indicating other factors are at play.

Area of Science:

  • Cardiovascular Health
  • Health Disparities Research
  • Clinical Hypertension Management

Background:

  • Black individuals with hypertension exhibit higher rates of uncontrolled blood pressure compared to White individuals.
  • Physician trust is a potential factor influencing blood pressure control, yet its role in racial disparities remains understudied.

Purpose of the Study:

  • To investigate the association between trust in physicians and blood pressure control in Black and White patients undergoing hypertension treatment.
  • To explore whether physician trust mediates racial differences in blood pressure management.

Main Methods:

  • Analysis of baseline data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study.
  • Inclusion of 2843 Black and White adults over 45 with treated hypertension, assessed via telephone surveys and in-home blood pressure measurements.
  • Definition of uncontrolled blood pressure based on established clinical guidelines, with adjusted criteria for participants with diabetes, renal disease, or prior myocardial infarction.

Main Results:

  • No significant association was found between trust in physicians and uncontrolled blood pressure in either unadjusted or adjusted analyses.
  • Black race was independently associated with increased odds of uncontrolled blood pressure (OR 1.58).
  • Imperfect medication adherence also correlated with higher odds of uncontrolled blood pressure (OR 1.56).

Conclusions:

  • Physician trust does not appear to be a significant factor in blood pressure control among treated hypertensive Black and White adults in this cohort.
  • The observed racial disparity in blood pressure control is not fully explained by physician trust or medication adherence.
  • Further research is necessary to elucidate the complex mechanisms underlying racial disparities in hypertension management.
Abstract

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