Document Detail


Racial differences in two self-management hypertension interventions.
MedLine Citation:
PMID:  21531237     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Only one half of Americans have their blood pressure controlled, and there are significant racial differences in blood pressure control. The goal of this study was to examine the effectiveness of 2 patient-directed interventions designed to improve blood pressure control within white and non-white subgroups (African Americans, 49%).
METHODS: Post hoc analysis of a 2 by 2 randomized trial with 2-year follow-up in 2 university-affiliated primary care clinics was performed. Within white and non-white patients (n=634), 4 groups were examined: 1) usual care; 2) home blood pressure monitoring (3 times per week); 3) tailored behavioral self-management intervention administered via telephone by a nurse every other month; and 4) a combination of the 2 interventions.
RESULTS: The overall race by time by treatment group effect suggested differential intervention effects on blood pressure over time for whites and non-whites (systolic blood pressure, P=. 08; diastolic blood pressure, P=.01). Estimated trajectories indicated that among the 308 whites, there was no significant effect on blood pressure at 12 or 24 months for any intervention compared with the control group. At 12 months, the non-whites (n=328) in all 3 intervention groups had systolic blood pressure decreases of 5.3 to 5.7 mm Hg compared with usual care (P <.05). At 24 months, in the combined intervention, non-whites had sustained lower systolic blood pressure compared with usual care (7.5 mm Hg; P <.02). A similar pattern was observed for diastolic blood pressure.
CONCLUSION: Combined home blood pressure monitoring and a tailored behavioral phone intervention seem to be particularly effective for improving blood pressure in non-white patients.
Authors:
Hayden B Bosworth; Maren K Olsen; Janet M Grubber; Benjamin J Powers; Eugene Z Oddone
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The American journal of medicine     Volume:  124     ISSN:  1555-7162     ISO Abbreviation:  Am. J. Med.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-02     Completed Date:  2011-06-22     Revised Date:  2012-05-02    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  468.e1-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Center for Health Services Research in Primary Care, Durham VAMC, Durham, NC 27703, USA. hboswort@acpub.duke.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
African Americans / statistics & numerical data*
Aged
Antihypertensive Agents / administration & dosage*
Blood Pressure Monitoring, Ambulatory*
Confounding Factors (Epidemiology)
Female
Health Behavior
Health Status Disparities
Humans
Hypertension / diagnosis,  drug therapy,  ethnology*,  therapy*
Life Style*
Male
Middle Aged
Research Design
Self Care*
Telephone
United States / epidemiology
Grant Support
ID/Acronym/Agency:
R01 HL070713/HL/NHLBI NIH HHS; R01 HL070713-01A1/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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