Race-Specific Patterns of Treatment Intensification Among Hypertensive Patients Using Home Blood Pressure Monitoring: Analysis Using Defined Daily Doses in the Heart Healthy Lenoir Study.

Background: Racial disparities in blood pressure (BP) control persist, but whether differences by race in antihypertensive medication intensification (AMI) contribute is unknown.

Objective: To compare AMI by race for patients with elevated home BP readings.

Methods: This prospective cohort study followed adult patients from 6 rural primary care practices who used home BP monitoring (HBPM) and recorded/reported values.

A multicomponent quality improvement intervention to improve blood pressure and reduce racial disparities in rural primary care practices.

The Southeastern United States has the highest prevalence of hypertension and African Americans have disproportionately worse blood pressure control. The authors sought to evaluate the effect of a multicomponent practice-based quality improvement intervention on lowering mean systolic blood pressure (SBP) at 12 and 24 months compared with baseline among 525 patients, and to assess for a differential effect of the intervention by race (African Americans vs white). At 12 months, both African Americans (-5.

The association of health literacy and blood pressure reduction in a cohort of patients with hypertension: The heart healthy lenoir trial.

Objective: Lower health literacy is associated with poorer health outcomes. Few interventions poised to mitigate the impact of health literacy in hypertensive patients have been published. We tested if a multi-level quality improvement intervention could differentially improve Systolic Blood Pressure (SBP) more so in patients with low vs.

Lessons Learned From Implementing Health Coaching in The Heart Healthy Lenoir Hypertension Study.

Background: Health coaching is increasingly important in patient-centered medical homes.

Objectives: Describe formative evaluation results and lessons learned from implementing health coaching to improve hypertension self-management in rural primary care.

Methods: A hypertension collaborative was formed consisting of six primary care sites.

Perceived Social Standing, Medication Nonadherence, and Systolic Blood Pressure in the Rural South.

Purpose: Little is known about how perceived social standing versus traditional socioeconomic characteristics influence medication adherence and blood pressure (BP) among African American and white patients with hypertension in the rural southeastern United States.

Methods: Perceived social standing, socioeconomic characteristics, self-reported antihypertensive medication adherence, and BP were measured at baseline in a cohort of rural African American and white patients (n = 495) with uncontrolled hypertension attending primary care practices. Multivariate models examined the relationship of perceived social standing and socioeconomic indicators with medication adherence and systolic BP.

Health coaching interventions with a heart-healthy lenoir project client.

The Heart-Healthy Lenoir Project is a multi-study project designed to reduce the risk burden of heart disease in Lenoir County, North Carolina. This case report examines one client's experience in this project and the impact of health coaching interventions that were used. The client presented with unhealthy lifestyle behaviors and a systolic blood pressure (BP) of more than 200 mmHg.

The Heart Healthy Lenoir project--an intervention to reduce disparities in hypertension control: study protocol.

Background: Racial disparities in blood pressure control are well established; however the impact of low health literacy (LHL) on blood pressure has garnered less attention. Office based interventions that are created with iterative patient, practice and community stakeholder input and are rolled out incrementally, may help address these disparities in hypertension control. This paper describes our study protocol.