Abstract 054: Hypertension Treatment And Control In A New York City Healthcare System

Abstract

Background: We investigated the prevalence of and patient characteristics correlated with hypertension control in the Montefiore Health System, a large and predominantly minority healthcare system with locations in New York City and Southern portion of Upstate New York. Methods: Using outpatient care data, we included all individuals with hypertension defined by ICD 9/10 codes during 2018. Treatment and control status were defined by the presence of prescribed antihypertensive medication(s) and measured blood pressure (BP): Joint National Commission (JNC) criteria - < 140 / 90 mmHg; or American Heart Association/American College of Cardiology (AHA/ACC) criteria - <130 / 80 mmHg. We report the distribution of hypertension treatment and control by age, sex, and race/ethnicity. Results: Among 74,487 hypertensive patients [mean age 62 years ±14), 62% female, predominantly Black (42%) and Hispanic (41%), and low SES (-2.91 ±2.90)], 57% were treated, of which 57% had achieved BP control by JNC criteria and 23% by AHA/ACC criteria. Compared with untreated patients, those prescribed treatments were older (61%), more likely to be NH Black or Hispanic (60%), and report one or more comorbidities (76%) (all p<0.0001). Prevalence of BP control by JNC criteria was lowest for NH Black (53%, p<0.0001) and Hispanic (58%, p<0.0001) patients than NH White and Asian (64%), and highest in patients ≥60 years (63%, p<0.0001) and those with comorbidities (89%, p=0.002). Similar discrepancies were apparent at the 130/80 mmHg threshold. BP control characteristics did not vary by sex. Conclusions: Hypertension treatment and control rates in a large, urban health system were significantly lower than reported national averages. Overall, NH Whites had a lower likelihood of hypertension treatment; NH Black and Hispanic patients had significantly lower prevalence of control compared with other racial/ethnic groups, despite having higher treatment rates. Disparities in BP control by patient characteristics was heightened with the AHA/ACC criteria.