Increased health care access could improve BP control, lower CKD risk in Hispanic patients
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A published study suggests increasing access to health care could help improve blood pressure control for Hispanic patients — a population found to have low control rates — thereby reducing the risk for subsequent development or progression of chronic kidney disease.
According to Claudia M. Lora, MD, of the division of nephrology at UI Health, and colleagues, while previous studies have examined rates of hypertension awareness, treatment and control among patients with CKD, none have specifically considered Hispanics/Latinos which, the researchers noted, is the largest minority group in the United States.
On the other hand, the researchers wrote, these factors related to hypertension have been well-studied in the Hispanic population (with results indicating Hispanic patients tend to have lower rates of hypertension than white patients), but these studies did not focus on the associations with CKD.
“In view of the well-established association of hypertension with CKD progression,” they suggested, “it is important to perform more focused analyses on those with CKD.”
Defining hypertension as systolic BP as at least 140 mm Hg, diastolic BP of at least 90 mm Hg or use of antihypertensives, the researchers considered BP control in 1,774 Hispanic/Latino patients who were enrolled in the Hispanic Community Health Study/Study of Latinos (mean age, 49 years; 57% were female; 51% with BMI of greater than 30 kg/m2; 61% with health insurance; mean eGFR, 92 mL/min/1.73m2).
Of the study population, 51.5% had hypertension with researchers noting 78.1% of these patients were aware of their condition and that 70.4% were receiving treatment.
They found that a low proportion of individuals with hypertension had “adequate” BP control (32.6% had BP of less than 140/90 mm Hg and 17.9% had BP of less than 130/80 mm Hg).
Further analyses suggested that patients with hypertension were more likely to be older than 45 years old, of the male sex, and to have been born outside the United States. In addition, the researchers wrote that patients with hypertension were more likely to have an income less than $20,000, less than a high school education, no health insurance coverage and diabetes. Regarding subgroups within the population, patients with hypertension were more likely to be of Cuban or Puerto Rican background and were less likely to be of Mexican background.
Patients with hypertension also had lower eGFR than those without hypertension.
The researchers emphasized the odds of treatment for hypertension were more than twofold greater for patients with health insurance than for those without coverage, contending that “the strong association between health insurance coverage and BP control [suggests] that public health initiatives are needed to improve access to health care for this growing population.” – by Melissa J. Webb
Disclosures: The authors report no relevant financial disclosures.
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