Division of Preventive Medicine; University of Alabama at Birmingham, Birmingham, AL 35294, USA.
Ethn Dis. 2010 Summer;20(3):282-9.
Among persons treated for hypertension, Blacks are more likely to have uncontrolled blood pressure compared to Whites. Few studies have focused on trust in physicians as a potential contributor to this disparity in blood pressure (BP) control. The primary objective of this study was to assess the relationship between trust in physicians and blood pressure control among Blacks and Whites being treated for hypertension.
Cross-sectional analysis of baseline data collected from the REasons for Geographic And Racial Differences in Stroke cohort, a US national, population-based cohort study. Participants were recruited by telephone from 2003-2007, completed a telephone survey, and had BP measured during an in-home visit.
2843 Black and White adults aged > 45 years with treated hypertension.
Uncontrolled blood pressure was defined as systolic blood pressure > 140 mm Hg or diastolic blood pressure > 90 mm Hg. For participants with diabetes, renal disease, or self-reported previous myocardial infarction, uncontrolled blood pressure was defined as systolic blood pressure > 130 mm Hg or diastolic blood pressure > 80 mm Hg.
Trust in physicians was not associated with uncontrolled blood pressure in either unadjusted (odd ratio [OR] 1.07; 95% confidence interval [CI) 0.92, 1.25) or adjusted analyses (OR 0.97; 0.83, 1.14). Both Black race (OR 1.58; 1.36, 1.84) and imperfect medication adherence (OR 1.56; 1.31,1.86) were associated with higher odds of uncontrolled blood pressure.
Trust in physicians was not related to blood pressure control among Blacks and Whites with treated hypertension in this sample. The racial disparity in blood pressure control was not completely explained by trust in physicians or medication adherence, and a better understanding of the mechanisms leading to this disparity is needed.
在接受高血压治疗的人群中,与白人相比,黑人更有可能出现血压控制不佳的情况。很少有研究关注医生信任是否是导致血压控制差异的潜在因素。本研究的主要目的是评估医生信任与接受高血压治疗的黑人和白人血压控制之间的关系。
这是一项横断面分析,对美国全国性基于人群的队列研究——REasons for Geographic And Racial Differences in Stroke 队列的基线数据进行分析。2003-2007 年通过电话招募参与者,完成电话调查,并在家庭访视中测量血压。
2843 名年龄>45 岁、接受高血压治疗的黑人和白人成年人。
未控制的血压定义为收缩压>140mmHg 或舒张压>90mmHg。对于患有糖尿病、肾脏疾病或自述有既往心肌梗死的患者,未控制的血压定义为收缩压>130mmHg 或舒张压>80mmHg。
在未调整分析(比值比[OR]1.07;95%置信区间[CI]0.92,1.25)或调整分析(OR 0.97;0.83,1.14)中,医生信任均与未控制的血压无关。黑种人(OR 1.58;1.36,1.84)和不完美的药物依从性(OR 1.56;1.31,1.86)均与未控制血压的可能性更高相关。
在本研究样本中,接受高血压治疗的黑人和白人的血压控制与医生信任无关。血压控制的种族差异不能完全用医生信任或药物依从性来解释,需要更好地了解导致这种差异的机制。