Friedman Mark, Borum Marie L
George Washington University, Washington, DC, USA.
J Natl Med Assoc. 2007 May;99(5):525-6.
There are significant health disparities between African Americans and whites in the United States. While colon cancer screening aids in decreasing the morbidity and mortality from colon cancer in African Americans, other health risks may also be identified during gastroenterology consultations. This study evaluated whether there is a disparity in the prevalence of hypertension and hypertension management in African Americans compared to whites who are referred for colon cancer screening consultations. The medical records of 258 patients (90 African Americans and 168 whites) were reviewed. Seventy-two of 90 (80%) African-American patients and 42 of 168 (25%) white patients had hypertension. There was a statistically significant difference (p < 0.005) in the rate of hypertension in African Americans compared to whites. Medications were prescribed by their referring physicians for 42 (58%) of the hypertensive African Americans, with 36 noted to have inadequately controlled blood pressure. Thirty (42%) of the hypertensive African-American patients were never prescribed blood pressure medications. Medications were prescribed by their referring physician for 36 (86%) of the hypertensive white patients, with six noted to have inadequately controlled blood pressure. Six (14%) of the hypertensive white patients were never prescribed blood pressure medications. There was a statistically significant difference in the rate of blood pressure control (p = 0.007) between African-American and white patients who were referred for colon cancer screening. Increased efforts are necessary to identify critical health concerns of all patients and to decrease health disparities between African Americans and whites in the United States.
在美国,非裔美国人和白人之间存在显著的健康差异。虽然结肠癌筛查有助于降低非裔美国人结肠癌的发病率和死亡率,但在胃肠病学咨询过程中也可能发现其他健康风险。本研究评估了在接受结肠癌筛查咨询的非裔美国人与白人相比,高血压患病率及高血压管理方面是否存在差异。对258例患者(90例非裔美国人,168例白人)的病历进行了回顾。90例非裔美国患者中有72例(80%)患有高血压,168例白人患者中有42例(25%)患有高血压。与白人相比,非裔美国人的高血压患病率存在统计学显著差异(p < 0.005)。其转诊医生为42例(58%)患有高血压的非裔美国人开了药,其中36例血压控制不佳。30例(42%)患有高血压的非裔美国患者从未开过降压药。其转诊医生为36例(86%)患有高血压的白人患者开了药,其中6例血压控制不佳。6例(14%)患有高血压的白人患者从未开过降压药。接受结肠癌筛查转诊的非裔美国患者和白人患者在血压控制率方面存在统计学显著差异(p = 0.007)。有必要加大力度识别所有患者的关键健康问题,并减少美国非裔美国人和白人之间的健康差异。