Ethnic, gender, and age-related differences in treatment and control of dyslipidemia in hypertensive patients.

BACKGROUND

Demographic differences in management of concomitant lipid disorders among hypertensive patients may contribute to health disparities.

OBJECTIVES

Assess demographic differences in lipid control rates and treatment patterns among dyslipidemic hypertensive patients in primary care.

METHODS

Demographic information, blood pressure, LDL-cholesterol, and medications were obtained on 72,351 hypertensive patients from 262 primary care providers at 69 sites in the Southeast. Analysis focused on a dyslipidemic hypertensive subset.

RESULTS

Among 72,351 hypertensives, 38,116 were dyslipidemic. Fifty-two percent of patients did not have a cholesterol measurement documented in the past year. Women and patients <40 years old were less likely to have an annual cholesterol measurement than men and older, same-race counterparts (P < or = .001). Thirty-five percent of all hypertensive dyslipidemic patients had not been prescribed any anti-lipidemic medication, whereas 15% were on a statin and another anti-lipidemic. Women received fewer statin prescriptions than men (47.7% vs 65.1%, P < or = .0001). Fewer African Americans (AA) than Caucasians (C) reached LDL levels of <100 or <130 mg/dL (P < or = .0001). Among C and AA patients, those <40 years old were less likely than older, same-race counterparts to have reached LDL < 100 or <130 mg/dL (p < or = 001). Younger patients had fewer annual cholesterol measurements and were less likely to receive antilipidemic medication and to have LDL controlled than older, same-race counter-parts in each ethnic group (P < or = .0001).

CONCLUSIONS

Demographic characteristics of hypertensive patients, especially younger age group, are associated with significant differences in diagnostic testing, treatment, and control of hyperlipidemia in primary care. This primary care information can be used to guide education and policy interventions to improve outcomes and reduce disparities.