Racial and geographic differences in awareness, treatment, and control of hypertension - The REasons for geographic and racial differences in stroke study
Racial and geographic differences in awareness, treatment, and control of hypertension - The REasons for geographic and racial differences in stroke study
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DOI：
10.1161/01.str.0000217222.09978.ce
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发表时间：
2006-05-01
期刊：
影响因子：
8.3
通讯作者：
Howard, V
中科院分区：
文献类型：
--
作者：
Howard, G;Prineas, R;Howard, V
背景和目的：在美国，中风死亡率在“中风带”和黑人中较高。由于高血压是中风的主要危险因素，高血压管理（提高认识，增加治疗，改善控制）可能会减少这些disparity. Methods高血压的认识，治疗和控制进行了测量的原因中风的地理和种族差异研究，一个全国人口为基础的队列的黑人和白色参与者> 45岁。在编写本报告时，已登记11 701人。种族差异和地理差异结果--黑人参与者比白人更了解他们的高血压（比值比[OR]，1.31; 95% CI，1.07 - 1.59），如果知道自己的诊断，更有可能接受治疗（OR，1.69; 95%CI，1.40至2.05），但在接受高血压治疗的人中，他们比白人更不可能控制血压（OR，0.73; 95%CI，0.64至0.83）。没有证据表明中风带和其他地区对高血压的认识存在差异（OR，0.95; 95%CI，0.79 - 1.14），但有更好治疗的趋势（OR，1.15; 95% CI，0.97 - 1.37）和对照组（OR，1.11; 95%可信区间，0.98 - 1.30）。结论-这些发现表明，改善黑人血压控制的干预措施有望减少中风死亡率的种族差异。高血压意识缺乏实质性的地理差异，以及卒中带更好的治疗和控制趋势表明，高血压管理的差异可能不是卒中死亡率地理差异的主要因素。
Background and Purpose-Stroke mortality is higher in the "Stroke Belt" and among blacks in the United States. Because hypertension is the leading risk factor for stroke, hypertension management (raising awareness, increasing treatment, and improving control) may reduce these disparities.Methods-Hypertension awareness, treatment, and control were measured in the REasons for Geographic And Racial Differences in Stroke study, a national population-based cohort of black and white participants > 45 years of age. At the time of this report, 11 701 had been enrolled. Racial differences and geographic differences (between the Stroke Belt and other regions of the United States) were described.Results-Black participants were more aware than whites of their hypertension (odds ratio [OR], 1.31; 95% CI, 1.07 to 1.59) and more likely to be on treatment if aware of their diagnosis (OR, 1.69; 95% CI, 1.40 to 2.05), but among those treated for hypertension, they were less likely than whites to have their blood pressure controlled (OR, 0.73; 95% CI, 0.64 to 0.83). There was no evidence of a difference between the Stroke Belt and other regions in awareness of hypertension (OR, 0.95; 95% CI, 0.79 to 1.14), but there was a trend for better treatment (OR, 1.15; 95% CI, 0.97 to 1.37) and control (OR, 1.11; 95% CI, 0.98 to 1.30) in the Stroke Belt region.Conclusions-These findings suggest that interventions to improve blood pressure control among blacks are promising to reduce the racial disparity in stroke mortality. The lack of substantial geographic differences in hypertension awareness and the trend toward better treatment and control in the Stroke Belt suggest that differences in hypertension management may not be a major contributor to the geographic disparity in stroke mortality.