Boston David, Hwang Jun, Lucas Jennifer A, Marino Miguel, Larson Zoe, Sun Evelyn, Giebultowicz Sophia, Quiñones Ana R, Crookes Danielle M, Rodriguez Carlos J, Heintzman John
OCHIN Inc, Portland, OR, USA.
Department of Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, USA.
J Gen Intern Med. 2025 Sep 8. doi: 10.1007/s11606-025-09735-9.
Hypertension is the most prevalent reversible risk for cardiovascular morbidity and mortality. Blood pressure (BP) control is poor nationally and varies by race/ethnicity, and there is minimal understanding of the impact of country of origin.
To examine racial/ethnic disparities in BP control among high-risk patients and among Latino patients disaggregated by country of origin.
DESIGN, PATIENTS, MAIN MEASURES: Using electronic health record data from 1604 community-based clinics and employing logistic regression adjusted for patient-level covariates, control of final recorded BP (< 130/80) was assessed by race, ethnicity, language preference, and country of origin in 298,860 adult patients with at least one high-risk condition (diabetes, heart, vascular, chronic kidney disease) from 2012 to 2020. Data analysis was conducted from June 2023 to March 2024.
40.5% of all patients had a final BP reading of < 130/80 (controlled BP). Compared with non-Latino White, non-Latino Black patients showed the lowest odds of BP control (0.69 [95% CI 0.68-0.71]) and Latino patients the highest (OR 1.19, 95% CI 1.17-1.22), with Spanish-preferring and foreign-born subgroups driving that advantage. Foreign-born Latino patients showed the highest odds of BP control compared with non-Latino White patients (OR 1.42 [95% CI 1.37-1.48]), ranging widely by country of origin.
Race/ethnic disparities in BP control are evident in a multistate network of community-based health centers with significant variability by country of origin among Latino patients. Findings have vast implications for informing equitable clinical and public health strategies to treat patients with demonstrated difficulty achieving and maintaining BP control.
高血压是心血管疾病发病和死亡最常见的可逆转风险因素。全国范围内血压（BP）控制情况不佳，且因种族/族裔而异，对于原籍国的影响了解甚少。
研究高危患者以及按原籍国分类的拉丁裔患者在血压控制方面的种族/族裔差异。
设计、患者、主要测量指标：利用来自1604家社区诊所的电子健康记录数据，采用对患者层面协变量进行调整的逻辑回归分析，在2012年至2020年期间对298860名患有至少一种高危疾病（糖尿病、心脏病、血管疾病、慢性肾病）的成年患者，根据种族、族裔、语言偏好和原籍国评估最终记录血压（<130/80）的控制情况。数据分析于2023年6月至2024年3月进行。
所有患者中40.5%的最终血压读数<130/80（血压得到控制）。与非拉丁裔白人相比，非拉丁裔黑人患者血压控制的几率最低（0.69[95%CI 0.68 - 0.71]），拉丁裔患者最高（OR 1.19，95%CI 1.17 - 1.22），以偏好西班牙语和出生在国外的亚组最为突出。与非拉丁裔白人患者相比，出生在国外的拉丁裔患者血压控制的几率最高（OR 1.42[95%CI 1.37 - 1.48]），因原籍国不同差异很大。
在一个多州的社区卫生中心网络中，血压控制方面种族/族裔差异明显，拉丁裔患者中因原籍国不同差异显著。这些发现对于制定公平的临床和公共卫生策略以治疗在实现和维持血压控制方面存在困难的患者具有重大意义。
