We read with interest the article by Rehman and colleagues1 in which they suggest that better access to care may help raise blood pressure (BP) control rates in African American hypertensive male patients closer to those achieved in white male hypertensive patients. While socioeconomic factors could contribute to racial disparity in BP control rates, one would expect them to be equally prominent for African American patients of both sexes when compared with their white counterparts. The National Health and Nutrition Examination Survey (NHANES) 1999-20002 cited by Rehman et al1 also found poorer hypertension control rates among African American men, yet no difference in BP control was noted between African American and white women. In their study, Rehman et al1 looked just at the male hypertensive population and offered no explanation for this sex-related difference among African Americans. Qualitative differences in pharmacotherapy and their possible impact on ethnic BP control rates at Veterans Affairs (VA) and non-VA health care sites were also not specifically discussed.
Oremus K, Oremus ZS. Sex, Not Just Race. Arch Intern Med. 2005;165(20):2432–2433. doi:10.1001/archinte.165.20.2432-b