title: Antihypertensive therapy in African Americans: findings from an inner-city ambulatory clinic.
abstract: African Americans bear a greater burden of hypertension. Understanding prevailing epidemiologic patterns can facilitate the implementation and successful outcome of community programs. The authors assessed practice patterns of antihypertensive drug utilization and blood pressure (BP) control in a predominantly African American population in Brooklyn, NY, from January 1 to January 31, 2008. A total of 416 (53.1%) had hypertension, with a mean age of 61 years, and 267 (64%) were women. In general, 212 (50.9%) were at goal BP and 59.9% of those at goal were taking at least 2 drugs. Patient age correlated with the number of drugs used (r=0.14; P=.004). Patients taking beta-blockers and calcium channel blockers were older: 63.6 vs 60.1 years (P=.01) and 62.7 vs 60.3 years (P=.07), respectively. The pattern of antihypertensive use was as follows: angiotensin-converting enzyme inhibitors, 194 (46.6%); calcium channel blockers, 162 (38.9%); diuretics, 162 (38.9%); beta-blockers, 133(32%); and angiotensin receptor blockers, 93 (22.4%). The findings of age associated with the class of medications used and a predominance of angiotensin-converting enzyme inhibitors usage highlight possible gaps in appropriateness of antihypertensive therapy. The application of age-appropriate race-based antihypertensive therapy might improve BP control rates. These results strengthen arguments for investing in community-based programs to overcome possible provider-related and local health system barriers to achieving BP control goals.
authors.affiliation: Department of Medicine, Yale University School of Medicine (Bridgeport Hospital), Bridgeport, CT, USA. sesky146@yahoo.com
authors.forename: Esosa
authors.initials: E
authors.lastname: Odigie-Okon
authors.forename: Stuart
authors.initials: S
authors.lastname: Zarich
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Okon
authors.forename: Alix
authors.initials: A
authors.lastname: Dufresne
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000554:Ambulatory Care Facilities; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D009519:New York City; D011159:Population Surveillance; D012189:Retrospective Studies; D014505:Urban Population
chemical_list: D000959:Antihypertensive Agents