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Evaluating the relationship between primary care provider access and high blood pressure among Hispanic patients: a
Catalina Yepez1, Kimberly McKeirnan2,3, Megan Undeberg4
1Pharmacotherapy Department, Washington State University College of Pharmacy and Pharmaceutical Sciences, 200 University Parkway, Yakima, WA, 98901, USA.
Insights
Having a primary care physician (PCP) is linked to better blood pressure control in Hispanic/Latino adults. Community health fairs can help connect individuals with PCPs to manage hypertension effectively.
Area of Science:
- Public Health
- Cardiology
- Health Disparities
Background:
- Access to a primary care physician (PCP) is crucial for managing chronic conditions like hypertension.
- Limited PCP access disproportionately affects underserved populations, potentially leading to uncontrolled blood pressure (BP).
- This study investigated the association between PCP status and uncontrolled BP in a predominantly Hispanic/Latino community health fair population.
Purpose of the Study:
- To determine if having a PCP is associated with controlled blood pressure (BP) among Hispanic/Latino adults.
- To identify factors influencing BP control in an underserved community.
- To inform strategies for improving hypertension management and reducing health disparities.
Main Methods:
- Cross-sectional study at a community health fair in Yakima County, Washington.
- Data collected on blood pressure, PCP status, insurance, demographics, and hypertension diagnosis from 218 participants (≥18 years).
- Uncontrolled BP defined as systolic ≥140 mmHg or diastolic ≥90 mmHg; analyses adjusted for confounders using robust Poisson regression informed by a directed acyclic graph (DAG).
Main Results:
- 33% of participants had uncontrolled BP; 84% identified as Hispanic, 63% were female.
- Individuals without a PCP had a significantly higher prevalence of uncontrolled BP (59% vs. 42%, p=0.002).
- Having a PCP was independently associated with lower prevalence of uncontrolled BP (PR=0.54; 95% CI: 0.35-0.85, p=0.007) after full adjustment.
Conclusions:
- A consistent relationship with a PCP is independently linked to better blood pressure control.
- Expanding PCP access in underserved communities can improve hypertension management and reduce disparities.
- Community health fairs are valuable for identifying individuals with uncontrolled BP and facilitating primary care linkage.
Background:
Access to a primary care physician (PCP) is essential for managing chronic diseases. Limited PCP access in underserved populations can lead to undiagnosed or poorly managed hypertension. This cross-sectional study assessed the association between having a PCP and uncontrolled blood pressure (BP) among predominantly Hispanic or Latino attendees of a community health fair, adjusting for identified confounders.
Methods:
Data were collected from participants aged 18 years or older at Fiesta de Salud, a community health fair held in Yakima County, Washington State, in August 2023. Blood pressure, PCP status, insurance coverage, demographics, and self-reported hypertension diagnoses were recorded. Uncontrolled BP was defined as systolic ≥ 140 mmHg or diastolic ≥ 90 mmHg. Bivariate analyses utilized Pearson's chi-squared tests. Variable selection for adjusted robust Poisson regression was informed by a directed acyclic graph (DAG), subsequently adjusting for demographics (gender and age), socioeconomic (insurance status), and clinical (prior hypertension diagnosis) confounders. Only complete cases were included for analysis.
Results:
Of the 218 participants analyzed, 84% identified as Hispanic, 63% were female. Uncontrolled BP prevalence was 33%. Participants without a PCP had significantly higher prevalence of uncontrolled BP (59% vs. 42%, p = 0.002). Having a PCP consistently lowered the prevalence of uncontrolled BP across all models, remaining significant in the fully adjusted model (PR = 0.54; 95% CI: 0.35-0.85, p = 0.007). Adjustment variables identified by the DAG were included to reduce confounding.
Conclusions:
Having a PCP was independently associated with better BP control after adjusting for demographic, socioeconomic, and clinical confounders. Expanding access to consistent PCP relationships, particularly in underserved communities, may improve hypertension management and reduce disparities. Community health fairs can play an important role by identifying individuals with uncontrolled blood pressure and facilitating linkage to ongoing primary care.
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