Abstract
Abstract
Background
This study assessed differences in blood pressure control rates and systolic blood pressure (SBP) values at Cook County Health (CCH) implementing the AMA MAP Hypertension quality improvement program, with the goal of identifying variations across demographic subgroups, including race, ethnicity, sex, and age.
Methods
We conducted a retrospective cohort study at CCH, comparing a 2-year historical pre-intervention period with a subsequent 2-year period encompassing implementation and post-implementation. Within each demographic subgroup, control rates were calculated as the proportion of patients with controlled blood pressure. Univariate analyses assessed changes in blood pressure (BP) control over time. Prevalence ratio estimates were calculated to understand the likelihood of having controlled blood pressure. Paired t-tests evaluated within-group changes in SBP, and an ANCOVA was conducted to compare SBP changes between groups while adjusting for baseline SBP.
Results
Overall, blood pressure control rates increased over time. However, Black patients were less likely than White patients to have controlled blood pressure both before (PR 0.91 [CI: 0.87-0.96]) and after (PR 0.96 [0.92-0.99]) the implementation of the program. SBP improved across all demographic groups, including Hispanic (−5.74 [CI: 6.19 to −5.29]) and Non-Hispanic patients (−4.92 [−5.21 to −4.63]), White (−5.96 [CI: −6.45 to −5.47]) and Black (−4.80 [CI: −5.11 to −4.49]) patients, and patients 45-64 years of age (−5.79 [CI: −6.12 to −5.46]) and patients 65-85 years of age (−4.31 [CI: −4.68 to −3.94]).
Conclusions
The AMA MAP Hypertension quality improvement program led to improvements in blood pressure control; however, gaps persisted in SBP values between ethnicity, race, and age.