Large Study Reports On Multiple Variables Affecting Compliance
While I prefer and typically insist on reviewing the published article describing a clinical study before posting on it, this meeting report/press release from the American Heart Association regarding the presentation at that organization’s 61st Annual Fall Conference of the Council for High Blood Pressure Research of a large survey of patients being treated for hypertension contains enough information with potential impact on clinical practice that I have excerpted significant portions relevant to compliance for this post, appending only the caveat that, again, I have not seen the full writeup and cannot warrant the completeness or accuracy of this data beyond the referenced report.
The Study
To obtain a clearer picture of high blood pressure treatment in their state, David J. Reynen, M.P.P.A., M.P.H., lead author of the study, and his colleagues at the California Department of Public Health’s Heart Disease and Stroke Prevention Program in Sacramento proposed a series of questions to be included in the California Health Interview Survey, which is conducted by telephone every two years, and then analyzed the results.
Of 42,044 California adults, 11,467 said a doctor had told them they had high blood pressure. When adjusted for age, this yielded a prevalence rate of 24.5 percent.
Of those diagnosed with hypertension, 49.4 percent were not taking drugs to lower it.
People who had seen a physician during the prior year were more than five times more likely to be on medication than were those who had not. [My emphasis] “That was informative,” said David J. Reynen, M.P.P.A., M.P.H., lead author of the study. “It really underscores the importance of having routine care.” “Unfortunately, the data are collected in such a way that we don’t know to what degree the individual respondents have hypertension,” Reynen said. “One in four adults in California, including one in three African Americans, is hypertensive,” he said. “We talk about people needing to know their numbers. That means not just whether your blood pressure is high or low, but your actual numbers. This study reinforces that.”
Among those surveyed with high blood pressure, the analysis showed that the age-adjusted odds of a person taking drugs to lower blood pressure are:
- 5.23 times higher for people who saw a physician within the past year compared to those who did not;
- 2.47 times higher for those with diabetes than those without the disease;
- 2.05 times higher for those who had health insurance than those who did not;
- 1.71 times higher for African Americans than for whites (the racial/ethnic groups, respectively, with the highest and lowest high blood pressure rate);
- 1.46 times higher for people who described their health as poor or fair compared to those in good health;
- 1.40 times higher for patients diagnosed with heart disease than those without it;
- 1.38 times higher for smokers than nonsmokers;
- 1.27 times higher for U.S.-born individuals than foreign-born;
- 1.21 times higher for people with some form of formal education after graduating high school than those with less formal education.
The age-adjusted prevalence of high blood pressure and drug treatment sometimes varied considerably among the various groups surveyed:
- African Americans had the highest prevalence of high blood pressure (35 percent), followed by American Indians (29.8 percent), Pacific Islanders (27.2 percent), those of other race/ethnicity (25.9 percent), Latinos (25.0 percent), Asians (24.5 percent) and whites (23.1 percent).
- African Americans had the highest rate of drug use to control their high blood pressure (56.6 percent), followed by American Indians (53.1 percent), Asians (52.1 percent), Pacific Islanders (52 percent), whites (49 percent), Latinos (45.8 percent) and those of other race/ethnicity (44.4 percent).