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通过心力衰竭疾病管理项目消除西班牙裔和黑人在高血压护理方面的差异。

Eliminating disparities in hypertension care for Hispanics and blacks using a heart failure disease management program.

作者信息

Hebert Kathy, Julian Elyse, Alvarez Jorge, Dias Andre, Tamariz Leonardo, Arcement Lee, Quevedo Henry C

机构信息

University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL 33136, USA.

出版信息

South Med J. 2011 Aug;104(8):567-73. doi: 10.1097/SMJ.0b013e318224dd18.

Abstract

OBJECTIVES

This study assessed if patients enrolled in a heart failure disease management program (HFDMP) reach the JNC VII target goals for blood pressure (BP) control, eliminate disparities in hypertension control by race/ ethnicity and the impact BP control has on survival.

METHODS

Patients (N = 898) with an ejection fraction <40% were enrolled into two HFDMPs and screened for hypertension, defined as BP > 130/80.

RESULTS

Mean baseline systolic BP (SBP) 132 ± 25.5 mm Hg and diastolic BP (DBP) 79 ± 16.8 mm Hg. Final mean SBP decreased to 129.6 mm Hg, DBP 77.6 mm Hg. Whites had the highest rate of achieving BP goals. Mortality reduction was associated with minority race, history of hypertension, increase ejection fraction and statin use.

CONCLUSION

HFDMPs are an effective way to reduce BP in hypertensive patients. Disparities by race and ethnicity were not seen after adjustment for disease modifiers. There was no mortality difference in those who reached BP goal.

摘要

目的

本研究评估参加心力衰竭疾病管理项目(HFDMP)的患者是否达到美国国家联合委员会第七次报告(JNC VII)的血压(BP)控制目标,消除种族/族裔在高血压控制方面的差异,以及血压控制对生存率的影响。

方法

射血分数<40%的患者(N = 898)被纳入两个HFDMP,并筛查高血压,高血压定义为血压>130/80。

结果

平均基线收缩压(SBP)为132±25.5毫米汞柱,舒张压(DBP)为79±16.8毫米汞柱。最终平均SBP降至129.6毫米汞柱,DBP降至77.6毫米汞柱。白人达到血压目标的比例最高。死亡率降低与少数族裔、高血压病史、射血分数增加和使用他汀类药物有关。

结论

HFDMP是降低高血压患者血压的有效方法。在对疾病修饰因素进行调整后,未发现种族和族裔差异。达到血压目标的患者死亡率无差异。

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