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Low Diuretic Use in Home Care for Blacks With Hypertension

Despite guidelines, majority of blacks with uncontrolled hypertension don't receive diuretics

THURSDAY, Jan. 31 (HealthDay News) -- A majority of black patients enrolled in an urban home health organization who have uncontrolled hypertension are not receiving diuretic antihypertensive medication, despite guideline recommendations regarding the important role diuretics play in hypertension control, according to research published in the February issue of the American Journal of Hypertension.

Linda M. Gerber, M.D., of the Weill Cornell Medical College in New York City, and colleagues evaluated the use of diuretics in a population of 658 black patients with uncontrolled hypertension.

In this patient population, 5.5 percent were not receiving any antihypertensive medication and 54 percent were not receiving a diuretic. Nonuse of diuretics was significantly associated with fewer antihypertensive medications, higher average diastolic blood pressure, and systolic blood pressures of 160 mm Hg or higher. Diuretic use was associated with lower average systolic and diastolic blood pressures (5 and 4 mm Hg lower, respectively).

"The main finding in this report is that in a sample of black patients receiving home care, fewer than half of those who had uncontrolled hypertension were taking a diuretic of any kind," the authors write. "Fewer than half of patients who were prescribed 1 or 2 drugs were prescribed a diuretic, indicating that the diuretics are not being chosen as the first or second line of treatment for the majority of patients. Even among those who were prescribed ≥3 drugs, 21.5 percent were not taking a diuretic."

Abstract (http://ajh.oxfordjournals.org/content/early/2012/12/27/ajh.hps029.abstract )Full Text (http://ajh.oxfordjournals.org/content/early/2012/12/27/ajh.hps029.full.pdf+html )