Uncontrolled hypertension linked to patients' perceived good health

24 June 2008

Medwire News: Untreated and uncontrolled blood pressure in young-to-middle age hypertensive patients are linked to a perception of good health and lack of need to regularly see a doctor, particularly among Black men, a US study reveals.

The findings could help explain why hypertension control rates in the USA remain lower in Black than White individuals, particularly among those under the age of 65 years.

Ronald Victor (University of Texas Southwestern Medical Center at Dallas, USA) and colleagues studied 1514 hypertensive patients, aged 18 to 64 years, living in Dallas County, Texas, from 2000 to 2002.

Participants completed a 90-minute structured computer-assisted health interview in their homes. They gave information about their awareness, treatment, and control of hypertension, their beliefs about the condition, demographic characteristics, and healthcare access and use, self-reported medical conditions, family history, and social support.

Each participant's blood pressure was measured after the interview.

As reported in the Archives of Internal Medicine, 24.5% of the participants had hypertension, and of these 64.4% were aware of their condition, 50.6% were being treated, and 26.9% had their blood pressure controlled.

Among the participants with hypertension, awareness, treatment, and control of hypertension were all negatively associated with a common perception of good health, at odds ratios (ORs) of 0.37, 0.47, and 0.66, respectively.

Each of these variables was also associated with having a regular doctor, at corresponding ORs of 3.81, 8.36, and 5.23.

Among untreated patients, men and Black individuals were twice as likely as women and individuals of other race or ethnicity, respectively, to report a perceived lack of need to see a physician regularly.

None of the hypertension outcomes were associated with perceived racism or lay beliefs about causes, consequences, and treatment of hypertension.

"These factors merit greater emphasis in professional education and public health programs on hypertension," the authors conclude.

Arch Intern Med 2008; 168: 1285-1293