Abstract 439: Gender and Racial Trends in Blood Pressure Control in a University-Based Cardiology Clinic
Background: Gender and racial differences may influence control of coronary disease risk factors, and have been partially attributed to socioeconomic issues.
Methods: Encounters from a university-based primary cardiology clinic with broad referral base were analyzed for BP by gender and race in patients with hypertension as a diagnosis.
Results: 200 encounters were analyzed: 105 (53%) females; systolic BP (SBP) 134 ± 20 mmHg compared with 95 (47%) males; SBP 130 ± 18 mmHg (NS). There were 100 (50%) African American patients; SBP 134 ± 20 mmHg compared with 100 (50%) White patients; SBP 130 ± 18 mmHg (NS). Comparing each subgroup to the remainder of the patients revealed African American females (AAF) with SBP of 137 ± 21 mmHg (P < 0.01), White females with SBP 129 ± 19 mmHg (NS), African American males with SBP 128 ± 18 mmHg (NS), White males SBP 131 ± 18 mmHg (NS). Diastolic BP was 83 ± 13 mmHg in AAF compared with 78 ± 11 mmHg in the remaining groups (P < 0.01). Age, heart rate, LDL levels and weights in AAF were 59 ± 13 years, 70 ± 10 BPM, 91 ± 44 mg/dL and 214 ± 77 lbs compared with 61 ± 13 years, 70 ± 12 BPM, 88 ± 38 mg/dL and 209 ± 68 lbs respectively in the remaining patients (NS).
Conclusion: African American females with treated hypertension had the highest documented BP during their clinic visits. Lack of compliance with medications is unlikely because these patients had insurance and their LDL levels were adequately controlled with medications. Body weight, though not statistically significant, may have contributed to the elevated BP in AAF. White-coat-hypertension is another potential explanation, which has been previously reported to be prevalent in African American females. This is an important observation given that approximately 50% of AAF patient in our cohort had treated diabetes requiring stricter BP control, compared with 25% in the other groups. Further studies with ambulatory BP monitoring may help better explain this observation. AAF remain at exceptional risk for cardiovascular disease; efforts to improve detection and control of hypertension, in addition to other cardiac risk factors, in this vulnerable ethnic/gender segment of the population are of paramount importance.
Author Disclosures: E. Ul Haq: None. M. Omar: None. B.A. Omar: None.
- © 2014 by American Heart Association, Inc.