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Financial cost as an obstacle to hypertension therapy.

N B Shulman, B Martinez, D Brogan, A A Carr and C G Miles

A home health interview, including blood pressure measurements, was conducted on 4,688 adults representing the noninstitutionalized population of Georgia. Subjects with diastolic blood pressure greater than or equal to 90 mm Hg or on antihypertensive medication were considered hypertensive. The prevalence of uncontrolled moderate or severe hypertension (diastolic greater than or equal to 105 mm Hg) was 1.9 per cent. With the exception of White women, all race-sex groups with uncontrolled moderate or severe hypertension reported substantially lower per capita income than their mild or controlled hypertensive counterparts. A larger percentage of the uncontrolled moderate to severe hypertensives on medication, as compared to their mild or controlled counterparts, reported economic barriers to pharmacologic and medical care on cost of medicines (36 per cent vs 22 per cent); refills (36 per cent vs 16 per cent); and office visits (26 per cent vs 16 per cent). Black women reported these barriers more than Whites. These findings suggest that costs of antihypertensive care may be an obstacle in blood pressure control for certain population subgroups.

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