Differential access to health care may contribute to lower blood pressure (BP) control rates to < 140/90 mm Hg in African American (AA) than Caucasian hypertensives, especially men (26.5% vs. 36.5% of all hypertensive patients in NHANES 1999-2000). The Veterans Administration (VA) system, which provides access to health care and medications across ethnic and economic boundaries, may reduce disparities in BP control. To test this hypothesis, BP treatment and control were compared in AA (VA N = 5252, non-VA N = 3859) and Caucasian (VA N = 9,656, non-VA N = 6,912) hypertensive men. In both groups, Caucasians were older than AA (p < .05), had lower BP (p < .001), and had BP controlled to < 140/90 mm Hg more often on their last visit (p < .01). BP control to < 140/90 was comparable among Caucasian hypertensives at VA (55.3%) and non-VA (55.4%) settings. In contrast, BP control was higher among AA hypertensives at VA (49.3%) than non-VA (43.2%) settings (p < .01). AA hypertensives received a comparable number of prescriptions for BP medications at VA sites and more prescriptions at non-VA sites compared to Caucasians (p < .01). AA had more visits in the previous year at VA sites (p < .01) and fewer visits at non-VA sites (p < .01) than Caucasians. BP control among AA is higher and ethnic differences in BP control less at VA than non-VA health care sites (6% vs. 12.2%, p < .01). Ensuring access to health care could constitute one constructive component of a national initiative to reduce ethnic disparities in cardiovascular risk.
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