Blood pressure control in Hispanics in the antihypertensive and lipid-lowering treatment to prevent heart attack trial.
Historically, blood pressure control in Hispanics has been considerably less than that of non-Hispanic whites and blacks. We compared determinants of blood pressure control among Hispanic white, Hispanic black, non-Hispanic white, and non-Hispanic black participants (N=32 642) during follow-up in a randomized, practice-based, active-controlled trial. Hispanic blacks and whites represented 3% and 16% of the cohort, respectively; 33% were non-Hispanic black and 48% were non-Hispanic white. Hispanics were less likely to be controlled (<140/90 mm Hg) at enrollment, but within 6 to 12 months of follow-up, Hispanics had a greater proportion <140/90 mm Hg compared with non-Hispanics. At 4 years of follow-up, blood pressure was controlled in 72% of Hispanic whites, 69% of Hispanic blacks, 67% of non-Hispanic whites, and 59% of non-Hispanic blacks. Compared with non-Hispanic whites, Hispanic whites had a 20% greater odds of achieving BP control by 2 years of follow-up (odds ratio: 1.20; 95% CI: 1.10 to 1.31) after controlling for demographic variables and comorbidities, Hispanic blacks had a similar odds of achieving BP control (odds ratio: 1.04; 95% CI: 0.86 to 1.25), and non-Hispanic blacks had a 27% lower odds (odds ratio: 0.73; 95% CI: 0.69 to 0.78). We conclude that in all patients high levels of blood pressure control can be achieved with commonly available medications and that Hispanic ethnicity is not associated with inferior control in the setting of a clinical trial in which hypertensive patients had equal access to medical care, and medication was provided at no cost.
Margolis
Karen L
KL
HealthPartners Research Foundation PO Box 1524, Mailstop 21111R, Minneapolis, MN 55440-1524, USA. Karen.L.Margolis@HealthPartners.com
Piller
Linda B
LB
Ford
Charles E
CE
Henriquez
Mario A
MA
Cushman
William C
WC
Einhorn
Paula T
PT
Colon
Pedro J
PJ
Vidt
Donald G
DG
Christian
Rudell
R
Wong
Nathan D
ND
Wright
Jackson T
JT
Goff
David C
DC
D000368:Aged; D017311:Amlodipine / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001262:Atenolol / Q000627:therapeutic use; D044383:Black People / Q000706:statistics & numerical data; D001794:Blood Pressure / Q000187:drug effects*; D002170:Canada; D002752:Chlorthalidone / Q000627:therapeutic use; D003000:Clonidine / Q000627:therapeutic use; D004311:Double-Blind Method; D017292:Doxazosin / Q000627:therapeutic use; D005260:Female; D006331:Heart Diseases / Q000517:prevention & control*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D006830:Hydralazine / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D017706:Lisinopril / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011647:Puerto Rico; D012110:Reserpine / Q000627:therapeutic use; D016896:Treatment Outcome; D014481:United States; D014767:United States Virgin Islands; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American
D000959:Antihypertensive Agents; D000960:Hypolipidemic Agents; D017311:Amlodipine; D006830:Hydralazine; D001262:Atenolol; D012110:Reserpine; D017706:Lisinopril; D003000:Clonidine; D017292:Doxazosin; D002752:Chlorthalidone