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Khatib R, Glowacki N, Lauffenburger J, et al. Race/Ethnic Differences in Atherosclerotic Cardiovascular Disease Risk Factors Among Patients With Hypertension: Analysis From 143 Primary Care Clinics. Am J Hypertens. 2021;34(9):948-955doi: 10.1093/ajh/hpab053.
Khatib, R., Glowacki, N., Lauffenburger, J., & Siddiqi, A. (2021). Race/Ethnic Differences in Atherosclerotic Cardiovascular Disease Risk Factors Among Patients With Hypertension: Analysis From 143 Primary Care Clinics. American journal of hypertension, 34(9), 948-955. https://doi.org/10.1093/ajh/hpab053
Khatib, Rasha, et al. "Race/Ethnic Differences in Atherosclerotic Cardiovascular Disease Risk Factors Among Patients With Hypertension: Analysis From 143 Primary Care Clinics." American journal of hypertension vol. 34,9 (2021): 948-955. doi: https://doi.org/10.1093/ajh/hpab053
Khatib R, Glowacki N, Lauffenburger J, Siddiqi A. Race/Ethnic Differences in Atherosclerotic Cardiovascular Disease Risk Factors Among Patients With Hypertension: Analysis From 143 Primary Care Clinics. Am J Hypertens. 2021 Sep 22;34(9):948-955. doi: 10.1093/ajh/hpab053. PMID: 33876823; PMCID: PMC8457428.
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Am J Hypertens. 2021 Sep 22;34(9):948-955. doi: 10.1093/ajh/hpab053.

Race/Ethnic Differences in Atherosclerotic Cardiovascular Disease Risk Factors Among Patients With Hypertension: Analysis From 143 Primary Care Clinics.

American journal of hypertension

Rasha Khatib, Nicole Glowacki, Julie Lauffenburger, Alvia Siddiqi

Affiliations

  1. Advocate Aurora Research Institute, Advocate Aurora Health, Downers Grove, Illinois, USA.
  2. Center for Healthcare Delivery Sciences, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
  3. Enterprise Population Health, Advocate Aurora Health, Downers Grove, Illinois, USA.

PMID: 33876823 PMCID: PMC8457428 DOI: 10.1093/ajh/hpab053

Abstract

BACKGROUND: While it is known that sex and race/ethnic disparities persist for atherosclerotic cardiovascular disease (ASCVD), disparities in risk factor control have not been well-described in primary care where ASCVD can be prevented.

METHODS: Adult patients with a hypertension diagnosis without ASCVD were included in this analysis of electronic health records from a large US healthcare system from 2018. Patients were categorized based on risk factor control defined as blood pressure (BP) <130/80 mm Hg; statin prescription among patients with indications, HbA1c of <7%, and not smoking. Multivariable Poisson regressions were developed to explore associations with race/ethnicity. Results are presented as relative risk (RR), 95% confidence intervals (CIs).

RESULTS: Among 5,227 patients, 55.8% women and 60.0% men had uncontrolled BP, 47.3% women and 46.4% men with statin therapy indication did not have a prescription, 34.9% women and 40.9% men had uncontrolled HbA1c values, and 9.3% women and 13.7% men were smokers. African Americans were more likely to have uncontrolled BP (women: RR 1.18, 95% CI 1.07-1.30; men: RR 1.20, 95% CI 1.05-1.34) and more likely to lack a statin prescription (women: RR 1.23, 95% CI 1.05-1.45; men: RR 1.25, 95% CI 1.03-1.51) compared to Caucasians. Differences in HbA1c control were not statistically significant among Hispanic/Latino compared to Caucasians (women: RR 1.28, 95% CI 0.86-1.90; men: RR 1.20, 95% CI 0.72-1.97).

CONCLUSIONS: Disparities in controlling ASCVD risk factors in primary care persist and were not fully explained by demographic or clinical characteristics. Monitoring changes in disparities is important to ensure equity as interventions to prevent ASCVD in primary care are developed and implemented.

© The Author(s) 2021. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd.

Keywords: CVD; blood pressure; clinical practice guidelines; disparities; hypertension; risk factor control

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