BP control programs may work better with community-based approach

To better alleviate racial disparities in BP outcomes, medical practitioners must take BP control programs to people in their communities, researchers wrote in a study published in Ethnicity & Disease.

“For people who can come to a clinic-based program, that program may work really well, but it’s not enough in and of itself to eliminate the racial disparities we see in efforts to reduce [BP] and other chronic diseases,” Lisa A. Cooper, MD, MPH, vice president of health care equity for Johns Hopkins Medicine and professor of medicine at the Johns Hopkins University School of Medicine, said in a press release.

To successfully beat hypertension, Cooper said, a more comprehensive strategy is needed.

A care management program that included three sessions of face-to-face contact time was implemented in six primary care practices in the Baltimore metropolitan region. Of the 3,964 patients with uncontrolled hypertension eligible for the study, 184 (5%) attended at least one care management session. An additional 445 patients were added to the program through primary care physician referral. Of the 629 patients who began the program, 245 (39%) completed all three sessions. Three hundred thirty-seven patients completed two sessions.

According to Cooper and colleagues, nearly half the patients received counseling about health barriers that were related to racial disparities. At the start of the program, black patients had higher systolic and diastolic BP compared with their white counterparts, as well as higher BMI.

Patients who completed the program were able to gain BP control (mean BP, 137/78 mm Hg) and had a 9 mm Hg systolic BP (P < .001) and 4 mm Hg diastolic BP (P = .004) greater improvement than patients who did not participate in the program. After intervention, black patients experienced the biggest reduction in BP, which eliminated any racial disparity.

“To stay healthy or treat chronic illness is not just about what happens in a 15- to 20-minute office visit to the doctor. What really matters is a person’s ability to follow through on recommendations regarding changes in diet, lifestyle and medication use the rest of the time as they go about their daily lives at home, at work and in the community,” Cooper said in the release. “In addition to addressing medical needs, health system programs should also address patients’ social, cultural and financial needs, using partnerships with other sectors of the community to enhance program effectiveness and outreach to those most in need.” by Tracey Romero

The researchers report no relevant financial disclosures.

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