Black adults with high blood pressure who are difficult to treat often do not receive appropriate medication or counseling about the use of healthy behaviors to lower blood pressure, according to a new study.
Previous studies have shown that blood pressure in black adults is more difficult to control than in white adults, and that achieving blood pressure control can prevent strokes, heart attacks, and other cardiovascular events in black adults each year.
A new study published Monday in the American Heart Association’s Hypertension focused on black adults with so-called tolerant hypertension, who need more than four drugs to control their blood pressure.
The researchers examined data from 1,776 black adults with resistant hypertension in the United States who took medication to lower blood pressure. First, they examined lifestyle factors, including body mass index, physical activity level, and whether a person smoked or drank alcohol. Next, we calculated how many participants took the recommended prescription medications for resistant hypertension.
They found that most study participants did not smoke or drink, but had low levels of physical activity: 82% had recommended moderate intensity 150 minutes or 75 minutes of activity per week. It was less than the intense activity of. Half of the participants did not report physical activity. In addition, the recommended BMI level was less than 10%.
Researchers also found that few people are taking the two drugs recommended for resistant hypertension. About 6% reported taking thiazide-like diuretics and about 10% taking mineralocorticoid receptor antagonists.
Lead author Aisha Langford said he wasn’t surprised by the low physical activity and low BMI score, as other studies in people with high blood pressure showed similar results. But she said it was “stunning” to discover that few people were taking the recommended medications.
Although the study barely investigated why the drug was prescribed, Dr. Langford is unaware of the 2018 AHA scientific statement recommending these two drugs for the treatment of resistant hypertension. It states that there is a possibility.
“Also, primary care clinicians may not have time to carefully choose antihypertensive drugs because they may treat patients with diabetes and many other health problems,” said Grossman, New York University. Langford, an assistant professor at the school, said. medicine.
Langford said he wants more doctors to use clinical decision support tools to find the right drug. She also encouraged healthcare professionals to spend more time educating patients, losing weight and activating physical activity.
“These things may really help, but they can be more difficult than taking tablets, so they aren’t always discussed,” she said.
She is conducting new research on decision-making shared between black adults and primary care physicians. This includes making decisions about proper nutrition to combat high blood pressure.
Some people confuse those who say, “What exactly is a healthy diet?” They say they haven’t heard of the DASH diet, an evidence-based dietary pattern that helps lower blood pressure, “Langford said.
She also sought further research to understand how doctors choose to prescribe certain types of blood pressure medications.
“This study is important because it shows that there is as much room for improvement at the patient, provider, and system level as we strive to control hypertension.” And Professor Johns Hopkins Nursing School, Vice President of Research.
Healthcare providers need to ask patients more questions and help them set and reach goals for lowering their blood pressure, said Himmelfarb, who was not involved in the new study.
She said patients should play a more active role, including monitoring blood pressure at home. “Studies have shown that this strategy helps individuals identify progress or lack of progress that may be related to their behavior.”
Himmelfarb encouraged people with high blood pressure to have open and continuous conversations with their doctors.
“It’s important not only to take the drug as prescribed, but to discuss with your provider the barriers you may have before you stop taking it, such as side effects and costs,” she said. “Healthcare providers and patients need to work together at a high level to achieve optimal results.”
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