title: Prescribing patterns in the treatment of hypertension among underserved African American elderly.
abstract: BACKGROUND
  Hypertension among African Americans is higher compared to Whites and has an early onset, greater severity, and is associated with more organ damage. We examined whether pharmaceutical treatment of hypertension among underserved African American elderly is consistent with the current treatment guidelines and whether treatment variations occur due to existing co-morbidities among the hypertensive.
  
  
  METHODS
  Our study surveyed 400 African Americans, aged ≥ 65 years, recruited from 16 predominantly African American churches located in South Los Angeles. The study used face-to-face interviews which documented type, frequency, and dosage of all medications used by participants. Label information of each drug was recorded.
  
  
  RESULTS
  Our data indicate: 1) 29% were on one anti-hypertensive medication; 60% were taking 2-3 medications; and 9% were on four classes of anti-hypertensive medication; 2) among the elderly taking a combination of two or more drugs, ACE or ARB was used 76% in combination of agents, diuretics 60%, calcium channel blockers 63%, and beta-blocker 61%; and 3) 26% of the elderly were taking ≥ 3 medications including a diuretic.
  
  
  CONCLUSIONS
  Treatment of hypertension appears to be inconsistent with the prevailing treatment guidelines for nearly one-third of the aged African Americans. Further investigation is needed to determine why a significant number of individuals from this under-served population are not receiving care based on established clinical guidelines.
authors.forename: Hamed
authors.initials: H
authors.lastname: Yazdanshenas
authors.forename: Mohsen
authors.initials: M
authors.lastname: Bazargan
authors.forename: Gail
authors.initials: G
authors.lastname: Orum
authors.forename: Leila
authors.initials: L
authors.lastname: Loni
authors.forename: Navid
authors.initials: N
authors.lastname: Mahabadi
authors.forename: Baqar
authors.initials: B
authors.lastname: Husaini
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D048909:Diabetes Complications / Q000150:complications / Q000208:ethnology / Q000628:therapy; D004232:Diuretics / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000208:ethnology*; D008297:Male; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000208:ethnology / Q000628:therapy; D012959:Socioeconomic Factors; D035862:Vulnerable Populations / Q000208:ethnology*
chemical_list: D000959:Antihypertensive Agents; D004232:Diuretics