title: Racial and Ethnic Differences in Antihypertensive Medication Use and Blood Pressure Control Among US Adults With Hypertension: The National Health and Nutrition Examination Survey, 2003 to 2012.
abstract: A key to reduce and eradicate racial disparities in hypertension outcomes is to understand their causes. We aimed at evaluating racial differences in antihypertensive drug utilization patterns and blood pressure control by insurance status, age, sex, and presence of comorbidities.
  
  
  
  A total of 8796 hypertensive individuals ≥18 years of age were identified from the National Health and Nutrition Examination Survey (2003-2012) in a repeated cross-sectional study. During the study period, all 3 racial groups (whites, blacks, and Hispanics) experienced substantial increase in hypertension treatment and control. The overall treatment rates were 73.9% (95% confidence interval [CI], 71.6%-76.2%), 70.8% (95% CI, 68.6%-73.0%), and 60.7% (95% CI, 57.0%-64.3%) and hypertension control rates were 42.9% (95% CI, 40.5%-45.2%), 36.9% (95% CI, 34.7%-39.2%), and 31.2% (95% CI, 28.6%-33.9%) for whites, blacks, and Hispanics, respectively. When stratified by insurance status, blacks (odds ratio, 0.74 [95% CI, 0.64-0.86] for insured and 0.59 [95% CI, 0.36-0.94] for uninsured) and Hispanics (odds ratio, 0.74 [95% CI, 0.60-0.91] for insured and 0.58 [95% CI, 0.36-0.94] for uninsured) persistently had lower rates of hypertension control compared with whites. Racial disparities also persisted in subgroups stratified by age (≥60 and <60 years of age) and presence of comorbidities but worsened among patients <60 years of age.
  
  
  
  Black and Hispanic patients had poorer hypertension control compared with whites, and these differences were more pronounced in younger and uninsured patients. Although black patients received more intensive antihypertensive therapy, Hispanics were undertreated. Future studies should further explore all aspects of these disparities to improve cardiovascular outcomes.
authors.affiliation: From the Department of Pharmacy Administration and Public Health, St. John's University, Queens, NY (A.G., R.P.D.); Paul H. Chook Department of Information Systems and Statistics, Baruch College, City University of New York (Y.Y.); and Division of Cardiology, Mt Sinai St. Luke's Hospital, New York, NY (E.A.). gus@stjohns.edu eargulian@chpnet.org.
authors.forename: Anna
authors.initials: A
authors.lastname: Gu
authors.affiliation: From the Department of Pharmacy Administration and Public Health, St. John's University, Queens, NY (A.G., R.P.D.); Paul H. Chook Department of Information Systems and Statistics, Baruch College, City University of New York (Y.Y.); and Division of Cardiology, Mt Sinai St. Luke's Hospital, New York, NY (E.A.).
authors.forename: Yu
authors.initials: Y
authors.lastname: Yue
authors.affiliation: From the Department of Pharmacy Administration and Public Health, St. John's University, Queens, NY (A.G., R.P.D.); Paul H. Chook Department of Information Systems and Statistics, Baruch College, City University of New York (Y.Y.); and Division of Cardiology, Mt Sinai St. Luke's Hospital, New York, NY (E.A.).
authors.forename: Raj P
authors.initials: RP
authors.lastname: Desai
authors.affiliation: From the Department of Pharmacy Administration and Public Health, St. John's University, Queens, NY (A.G., R.P.D.); Paul H. Chook Department of Information Systems and Statistics, Baruch College, City University of New York (Y.Y.); and Division of Cardiology, Mt Sinai St. Luke's Hospital, New York, NY (E.A.). gus@stjohns.edu eargulian@chpnet.org.
authors.forename: Edgar
authors.initials: E
authors.lastname: Argulian
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D017723:Drug Utilization Review; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology* / Q000639:trends; D006630:Hispanic or Latino; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology* / Q000503:physiopathology; D019458:Insurance Coverage; D007348:Insurance, Health; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D017057:Medically Uninsured / Q000208:ethnology; D008875:Middle Aged; D009749:Nutrition Surveys; D016017:Odds Ratio; D010818:Practice Patterns, Physicians'; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D044465:White People; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents
keywords: blood pressure; cardiovascular diseases; drug therapy; hypertension; treatment outcome