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Eliminating disparities in hypertension care for Hispanics and blacks using a heart failure disease management

Kathy Hebert1, Elyse Julian, Jorge Alvarez

  • 1University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL 33136, USA. khebert1@gmail.com

Southern Medical Journal
|September 3, 2011
PubMed

Insights

Heart failure disease management programs effectively lower blood pressure (BP) in hypertensive patients. While initial racial disparities in BP control were observed, they diminished after accounting for other health factors.

Area of Science:

  • Cardiology
  • Hypertension Management
  • Health Disparities Research

Background:

  • Heart failure disease management programs (HFDMPs) aim to improve patient outcomes.
  • Hypertension is a significant comorbidity in heart failure patients.
  • Achieving blood pressure (BP) control is crucial for managing heart failure and reducing cardiovascular events.

Purpose of the Study:

  • To evaluate if patients in a heart failure disease management program (HFDMP) achieve JNC VII blood pressure (BP) targets.
  • To determine if racial and ethnic disparities in hypertension control exist within HFDMPs.
  • To assess the impact of BP control on survival rates in heart failure patients.

Main Methods:

  • A cohort of 898 patients with ejection fraction <40% were enrolled in two HFDMPs.
  • Hypertension was defined as BP > 130/80 mm Hg.
  • Patients were screened for hypertension and BP control was monitored throughout the program.

Main Results:

  • Mean baseline systolic BP (SBP) was 132 ± 25.5 mm Hg and diastolic BP (DBP) was 79 ± 16.8 mm Hg.
  • Final mean SBP decreased to 129.6 mm Hg and DBP to 77.6 mm Hg.
  • Whites exhibited the highest rate of achieving BP goals; however, disparities were not evident after adjusting for disease modifiers. Mortality reduction was linked to minority race, hypertension history, increased ejection fraction, and statin use.

Conclusions:

  • HFDMPs demonstrate effectiveness in reducing BP among hypertensive heart failure patients.
  • Observed racial and ethnic disparities in BP control were mitigated by adjusting for disease modifiers.
  • No significant difference in mortality was found between patients who achieved BP goals and those who did not.
Abstract

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