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Greater access to care at VA clinics lessens disparities in blood pressure control among black men

During 1999-2000, 10 percent fewer black than white men with hypertension achieved blood pressure (BP) control to below 140/90 mm Hg (26.5 vs. 36.5 percent), according to the National Health and Nutrition Examination Survey. However, this disparity in blood pressure control was about 40 percent less at Veterans Affairs (VA) than at non-VA health care sites (6.2 vs. 10.2 percent), according to a study supported in part by the Agency for Healthcare Research and Quality (HS10871).

Greater access to care at VA sites seemed to underlie better control among black men, note the researchers who conducted the study. They compared BP treatment and control between black (4,379 at VA centers and 2,754 at non-VA centers) and white (7,987 at VA centers and 4,980 at non-VA centers) men with high blood pressure. In both groups, whites were older than blacks, had lower BP, and had their BP controlled to below 140/90 mm Hg more often at their last visit.

Blood pressure control to below 140/90 mm Hg was comparable among white men with hypertension at VA (55.6 percent) and non-VA (54.2 percent) sites. In contrast, BP control was higher among black men with hypertension at VA (49.4 percent) than non-VA (44 percent) sites, even after controlling for age, numerous comorbid conditions, and rural-urban location. Black men received a comparable number of prescriptions for BP medications at VA sites and more prescriptions at non-VA sites than did whites. Yet, blacks had more visits at VA sites and fewer visits at non-VA sites than whites. These results suggest that site of care (and especially more visits) had greater impact on BP control in blacks than in whites.

See "Ethnic differences in blood pressure control among men at Veterans Affairs clinics and other health care sites," by Shakaib U. Rehman, M.D., Florence N. Hutchison, M.D., Katharine Hendrix, Ph.D., and others, in the May 9, 2005, Archives of Internal Medicine 165, pp. 1041-1047.

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