Blood Pressure Control Less Likely in Poorer Areas, Research Finds
Even with equal care, individuals in low-income regions may face a greater chance of dying from any cause.
For those living in poorer parts of America, the rates of high blood pressure
Blood Pressure Control Less Likely in Poorer Areas, Research Finds
Even with equal care, individuals in low-income regions may face a greater chance of dying from any cause.
For those living in poorer parts of America, the rates of high blood pressure, heart failure, and stroke are greater than in areas where incomes are higher.
And a new study published July 31, 2019, in the Journal of the American Heart Association has found that even when individuals in low-income regions have equal access to medical therapy, they still have far worse health outcomes.
Andi Shahu, MD, a resident physician at Johns Hopkins Hospital in Baltimore, and colleagues reviewed data from 27,862 adults who were participating in ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial).
ALLHAT enrolled men and women ages 55 and older with untreated or treated hypertension throughout the United States, Canada, Puerto Rico, and the Virgin Islands from 1994 to 2002. Participants in lower income areas tended to be female, black, Hispanic, have fewer years of education, and live in the South.
This large clinical trial of high blood pressure treatment compared the effectiveness of three blood pressure–lowering drugs — a calcium channel blocker (amlodipine), an angiotensin-converting enzyme (ACE) inhibitor (lisinopril), and an alpha-adrenergic blocker (doxazosin).
No matter their income, the randomized participants had access to blood pressure–lowering medication, guidance on how to take the medication, and a doctor who followed standard protocols for medical treatment.
“We expected the intervention, on average, to result in similar blood pressure control across all groups,” says Dr. Shahu. “But this wasn’t the case; there were systemic differences by socioeconomic region.”
“Participants at sites in low-income areas were much less likely to achieve blood pressure control than those in high-income areas, even though they were all enrolled in the same clinical trial that implemented a standard protocol for checking blood pressure and changing medication in order to lower their blood pressure,” Shahu says.
“Likewise, participants in the low-income counties were also more likely to be hospitalized, pass away from complications related to heart failure, or be diagnosed with end-stage kidney disease,” he says.
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