Table 6.

Management of Hypertension, by Race

Author, year	Aims	Subjects	Characteristics of study population	Results
Bosworth, 200638	The research sought to determine the social, economic, and physical factors that may explain racial differences in blood pressure controls and determine the extent to which modifiable and nonmodifiable factors are related to blood pressure control.	569	98% male veterans 41% AA 59% white	African Americans were more likely to have inadequate blood pressure control compared with whites and more likely to be non adherent. African Americans were likely to perceive high blood pressure as very serious vs serious, to report a relative with HTN, to be illiterate, and to report increased urination as a side effect all of which were linked to poor blood pressure control. After adjustment, odds of African Americans having poor blood pressure control remained significant, as did increased urination.
Rehman, 200539	To determine whether the VA does better at reducing disparities in blood pressure control between African American and white hypertensive men than non-VA health care	12 366 VA, 7,734 non-VA	AA men: 4379 VA, 2754 non-VA; White men: 7987 VA, 4980 non-VA	Among VA patients whites were more likely to have blood pressure controlled at the last visit. AA and white veterans received a similar number of prescriptions at VA sites; African Americans, however, had more clinic visits in the previous year.
Lowry, 200540	To examine associations between patient characteristics, including reported adverse events, and both intentional and unintentional nonadherence among hypertension patients.	588	42.5% non white	Individuals who reported intentional non-adherence were significantly more likely to be non-white, report more than 5 adverse effects, and were less likely to have diabetes. Unintentional nonadherence was more likely among non-white veterans, those with less than a 10th grade education. In general, those reporting nonadherence were more likely to have uncontrolled blood pressure.
Sharkness, 199241	To examine veterans’ understanding of hypertension control and relate it to medication compliance.	125	74% AA	Univariate analysis showed that although 70% viewed hypertension as a symptomatic condition, symptoms were not significantly associated with pharmacy compliance. Univariate analysis showed that perceived lifetime treatment of hypertension, a greater than 5 year history of medication use, perceived cause of hypertension other than diet, use of more than 1 hypertension drug, lack or reported departure from prescribed regimen, absence of drug abuse history and white race were associated with compliance. In multivariate analysis, drug abuse history, perceived cause of hypertension and pattern of medication use best predicted compliance with hypertension regimens.

AA African American, HTN hypertension, VA Veterans Affairs