부산대학교 도서관

Introduction: Racial and socioeconomic disparities in hypertension prevalence and treatment have been observed over numerous decades. There is opportunity to close racial disparities by focusing resources on patient education, skill-building, and self-management.Methods: A hypertension-reduction program was established between an academic-affiliated FQHC in the southeast, the American Heart Association, the Centers for Disease Control, and the American College of Preventive Medicine using a multidisciplinary outreach model in the community setting. Participants included 265 high-risk patients from the FQHC with severe hypertension (>160/90 mm HG). Program activities included a weekly class where participants learned about hypertension, were trained to take their blood pressure (BP), and received cuffs to use at home. A prospective pre-post cohort design was used to evaluate this portion of the program. Participants’ attendance at the self-management classes was tracked along with BP measurements at every class attended.Results: Over the program’s first 6 months, 93 of the 265 recruited participants attended at least one of 28 BP management classes. The 29 participants who attended multiple classes achieved an average 19 mm HG reduction in systolic BP (p=0.004) and an average 14 mm HG reduction in diastolic BP (p=0.002).Patients who were Black were significantly more likely to attend multiple classes than patients who were Hispanic (p=0.004). Also, patients who were self-monitoring their BP prior to class attendance were significantly more likely to attend multiple classes than those who were not previously self-monitoring (p=0.014). Multiple class attendance was also associated with higher baseline BP (p=0.038 for systolic and p=0.018 for diastolic).Conclusions: Implementation of blood pressure self-management classes showed success in reducing hypertension among many of the high-risk participants. Hispanic patients were much less likely to attend multiple classes, underscoring the need for culturally and linguistically appropriate class content. The low proportion of Hispanic patients previously monitoring their BP points to an opportunity to improve patient awareness about hypertension among Hispanic populations generally.