%0 Journal Article
%T Race
%A Alan Hinderliter
%A Alyssa Adams
%A Beverly Garcia
%A Cassandra Miller
%A Crystal W. Cene
%A Darren DeWalt
%A Doyle M. Cummings
%A Edwin Little
%A Jacquie Halladay
%A Jim Tillman
%A Katrina E. Donahue
%A Quefeng Li
%J Annals of Pharmacotherapy
%@ 1542-6270
%D 2019
%R 10.1177/1060028018806001
%X Background: Racial disparities in blood pressure (BP) control persist, but whether differences by race in antihypertensive medication intensification (AMI) contribute is unknown. Objective: To compare AMI by race for patients with elevated home BP readings. Methods: This prospective cohort study followed adult patients from 6 rural primary care practices who used home BP monitoring (HBPM) and recorded/reported values. For providers, AMI was encouraged when mean HBPM systolic blood pressure (SBP) values were £¿135 mm Hg; patients received phone-based coaching on HBPM technique and sharing HBPM findings. AMI was assessed between baseline and 12 months using defined daily dose (DDD) and summed to create a total antihypertensive DDD value. Results: A total of 217 patients (mean age = 61.4 ¡À 10.2 years; 66% female; 57% black) provided usable HBPM data. Among 90 (41%) intensification-eligible hypertensive patients (ie, mean HBPM SBP values for 6-months £¿135 mm Hg), mean total antihypertensive DDD was increased in 61% at 12 months. Blacks had significantly higher mean DDD at baseline and 12 months, but intensification (+0.72 vs +0.65; P = 0.83) was similar by race. However, intensification was greater in males than females (+1.1 vs +0.39; P = 0.031). Reduction in mean SBP following intensification was greater in white versus black patients (£¿8.2 vs £¿3.9 mm Hg; P = 0.14). Conclusion/Relevance: Treatment intensification in HBPM users was similar by race, differed significantly by gender, and may produce a greater response in white patients. Differential AMI in HBPM users does not appear to contribute to persistent racial disparities in BP control
%K racial disparities
%K hypertension control
%K treatment intensification
%U https://journals.sagepub.com/doi/full/10.1177/1060028018806001