Eliminating Disparities in Hypertension Care for Hispanics and Blacks Using a Heart Failure Disease Management Program

Abstract

This study assessed if patients enrolled in a heart failure disease management program (HFDMP) reach the JNC VII target goals for blood pressure (BP) control, eliminate disparities in hypertension control by race/ ethnicity and the impact BP control has on survival. Patients (N = 898) with an ejection fraction <40% were enrolled into two HFDMPs and screened for hypertension, defined as BP > 130/80. Mean baseline systolic BP (SBP) 132 ± 25.5 mm Hg and diastolic BP (DBP) 79 ± 16.8 mm Hg. Final mean SBP decreased to 129.6 mm Hg, DBP 77.6 mm Hg. Whites had the highest rate of achieving BP goals. Mortality reduction was associated with minority race, history of hypertension, increase ejection fraction and statin use. HFDMPs are an effective way to reduce BP in hypertensive patients. Disparities by race and ethnicity were not seen after adjustment for disease modifiers. There was no mortality difference in those who reached BP goal.