Making a difference: managing hypertension in minority patients

Article Abstract:

High blood pressure (hypertension) can be a major contributing factor in the development of heart disease, stroke, and kidney failure if it is inadequately treated. Hypertension and its adverse health effects are more common in certain minority groups in the United States than in the white population. Most studies have found that blacks have the greatest incidence of hypertension, followed by Hispanics; these two groups are at substantially higher risk than Asians and non-Hispanic whites. While the rate of death from cardiovascular disease is falling in the US as a whole, this rate is decreasing less sharply for Hispanics than for blacks, whites, and Asians. One recent survey found that Hispanic-American men, as a group, are the least likely to be properly diagnosed and treated for high blood pressure. Some experts have suggested that the Hispanic community has limited access to medical care because of language barriers, cultural isolation, and the attitudes of peers. Blacks with hypertension reportedly have three to five times the rate of death from cardiovascular disease than white hypertensives have. Black people are also at greater risk for advancement of the disease to the point at which organs such as the kidneys are damaged. Hispanics and blacks have an elevated incidence of both obesity and diabetes, which can exacerbate hypertension, making it more difficult to control. Blacks and whites do not respond in the same way to certain antihypertensive drugs, but both groups can be effectively treated if the correct drugs are used. One important finding is that patients may be less likely to take a drug consistently if it is more expensive to obtain, therefore, the physician should carefully consider the cost of the medication that is prescribed. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Hypertension, cardiac disease, and compliance in minority patients

Article Abstract:

High blood pressure (hypertension) and its complications are more common among black Americans than among whites. It is estimated that 25 percent of black Americans have uncontrolled hypertension, in contrast with 16 percent of whites. Mortality from diseases associated with hypertension may be from 6 to 13 times greater among blacks than whites. Hispanics are also more prone to the adverse effects of hypertension. Members of these racial minorities are also more likely to be members of inner city populations, where access to health care is lower. In addition, inner city groups tend to be less inclined to seek health care and less likely to follow prescribed treatments. This problem is particularly severe for hypertension, which has no symptoms. A review of both population-based studies and experimental studies has identified several factors that may improve the effectiveness of treatment for hypertension among inner city residents. One factor is simply improved access to health care. This should not only include access to clinics, but also reimbursement for transportation. Education is very important; inner city residents are generally less educated, and are not likely to comply with prescribed treatment without an understanding of the risks involved. Furthermore, the prescribed treatment should be as simple as is medically possible. Compliance is less likely with a regimen involving two or more drugs than it is with one drug. While not all patients can be treated adequately with a single drug, the problem of compliance must be borne in mind when the prescriptions are written. Similarly, treatment with drugs delivered through transdermal patches may improve patient compliance, but may not be suitable for every patient. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, Demographic aspects, Dosage and administration, Antihypertensive drugs, Antihypertensive agents, Epidemiological research, Cross sectional studies

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Hypertension and cardiac disease in minorities

Article Abstract:

Cardiovascular disease is still the number one killer in the United States, and high blood pressure (hypertension) is a major risk factor. Uncontrolled hypertension can cause stroke, kidney disease, and heart disease. Many research studies have shown that the incidence of hypertension and its adverse effects is greater among blacks and Hispanics than among whites. Blacks tend to develop hypertension at a younger age, have a more rapid progression, and are more likely to be inadequately treated for this condition than whites. The rate of death from hypertensive disease is 6 to 13 times higher among blacks than among whites. Hispanics, as a population, fall between whites and blacks in terms of incidence and severity of hypertension. During the past 20 years, much progress has been made in diagnosing and treating high blood pressure; public education programs have played an important role in this effort. Because of better control of hypertension the death rate from complications has decreased substantially. However, among the black and Hispanic populations, this decline has been less pronounced. Two of the possible reasons for the persistence of high cardiovascular mortality in these groups include fewer medical facilities in minority neighborhoods and a tendency by minority patients not to seek health care services. A greater understanding of the physiological and epidemiological differences among the various ethnic groups in the US is needed to further reduce illness and death caused by hypertension. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cardiovascular diseases, Risk factors

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