PCV113 - Racial Variations In Antihypertensive Pharmacotherapy In Ambulatory Settings: Data From United States National Samples

Abstract

PCV113 RaCial VaRiations in antihyPeRtensiVe PhaRmaCotheRaPy in ambulatoRy settings: Data FRom uniteD states national samPles Chettupalli K.1, Gu A.2, Wu W.K.3 1ST JOHNS UNIVERSITY, fresmeadows, NY, USA, 2ST JOHNS UNIVERSITY, NY, USA, 3St. John’s University, Jamaica, NY, USA Objectives: Very few studies systematically investigated the differences in antihypertensive pharmacotherapy in ambulatory care settings among different racial groups. The objectives of the study include: 1) To compare antihypertensive prescription patterns by patient race in US ambulatory settings; 2) To determine factors affecting the recipient of each class of anti-antihypertensive regimen specific to racial groups. MethOds: All patient-physician encounters with primary diagnosis indicating essential hypertension (ICD-9 codes “401.0”, “401.1” and “401.9”) and patient age 18 years and older from National Ambulatory Medical Care Survey (NAMCS) for the years 2006-2010 were analyzed. Weighted univariate and bivariate analyses were performed to examine demographics and clinical characteristics in general and between the racial/ethnic groups. Multivariate logistic regression models were performed to investigate the adjusted likelihood of receiving each class of antihypertensive regimens by different racial groups, controlling for potential confounders. Results: A total of 12,674 visits were identified. The unadjusted prescription rates by race (African Americans vs. Caucasians) were 23.1% vs. 20.3% (diuretics), 21.9% vs. 29.5% (BBs), 21.2% vs. 26.5% (ACEIs), 18.5% vs. 16.7% (CCBs), 14.5% vs. 14.8% (Angiotensin II Receptor Blockers, ARBs), 6.6% vs. 5.9% (Antiadrenergic agents), and 47.2% vs. 45.2% (combination regimens). Weighted logistic regression analyses determined that African Americans were more likely to receive diuretics (OR= 1.396, P< .0001), Calcium Channel Blockers (BBs) (OR= 1.409, P< 0.0001), Anti-Adrenergic-agents (OR= 1.267, P= 0.0275), fixed-dose combinations (OR= 1.273, P= 0.0027), and multiple-pill-regimens (OR= 1.184, P= 0.0048) and less likely to receive ACEIs ( OR= 0.836, P= 0.0080), BBs (OR= 0.73, P< 0.0001) than Caucasians. Factors affecting the likelihood of receiving different classes of antihypertensive agents include patient age, gender, co-morbid conditions, insurance-status, and health education profile. cOnclusiOns: In US Ambulatory Care Settings, African American patients receive systematically different antihypertensive regimens than their Caucasian counterparts. Further studies are needed to disentangle the potential effects from health insurance and utilization patterns on the racial variations in antihypertensive pharmacotherapy.