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Diuretic use in black patients with uncontrolled hypertension

Linda M Gerber1, Samuel J Mann, Margaret V McDonald

  • 1Department of Public Health, Weill Cornell Medical College, New York, NY, USA. LIG2002@med.cornell.edu

American Journal of Hypertension
|February 6, 2013
PubMed

Insights

Despite guidelines, many black patients with uncontrolled hypertension are not prescribed diuretics. This study found that diuretic use was associated with better blood pressure control in this population.

Area of Science:

  • Cardiology
  • Public Health
  • Pharmacology

Background:

  • Current hypertension guidelines recommend diuretics as a primary treatment, especially for black patients and those with resistant hypertension.
  • Failure to adhere to these recommendations may lead to persistently high rates of uncontrolled hypertension.
  • This study investigated diuretic prescribing practices among black patients with uncontrolled hypertension receiving home health care.

Purpose of the Study:

  • To assess the prescribing patterns of diuretics in a specific population of black patients with uncontrolled hypertension.
  • To identify potential disparities in adherence to hypertension management guidelines.

Main Methods:

  • The study involved black participants aged 21-80 with hypertension, identified within an urban home health organization.
  • In-home interviews were conducted to collect data on prescribed antihypertensive medications for participants with uncontrolled hypertension.
  • Prescribing patterns were analyzed for 658 participants.

Main Results:

  • Only 46% of participants were prescribed a diuretic, and 5.5% received no antihypertensives.
  • Patients not on diuretics were on fewer medications, had higher diastolic blood pressure (89.2 vs 85.5 mmHg), and were more likely to have systolic blood pressure ≥160 mmHg (57.6% vs 49.0%).
  • Diuretic use was linked to lower adjusted systolic (5 mmHg) and diastolic (4 mmHg) blood pressures.

Conclusions:

  • A majority of black patients with uncontrolled hypertension in this sample were not receiving recommended diuretic therapy.
  • These findings highlight a significant gap between guideline recommendations and clinical practice for hypertension management in this demographic.
  • Continued attention and intervention are necessary to improve diuretic prescribing for uncontrolled hypertension in black patients.
Abstract

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