# Race/ethnic differences in guideline recommended hypertension medications in VHA

> **NIH VA IK2** · VA SALT LAKE CITY HEALTHCARE SYSTEM · 2021 · —

## Abstract

Among Veterans, hypertension is the most common chronic condition with a prevalence of 37%
and can lead to stroke, myocardial infarction, chronic kidney disease, and heart failure. Among
blacks, hypertension occurs earlier in life, is more prevalent and severe, and is less likely to be
controlled. While control of hypertension has significantly improved over recent years in the
Veterans Affairs (VA), from 46% in 2000 to 76% in 2010, disparities persist among blacks, and
reasons are not well understood. The Joint National Committee (JNC) publishes guidelines on
evidence-based medications for hypertension treatment. However, controversy remains
regarding the target blood pressure (BP) to achieve with therapy. The recently published
Systolic Blood Pressure Intervention Trial (SPRINT), a landmark clinical trial, is anticipated to
lead to changes in hypertension practices for patients with increased cardiovascular disease
risk and without a history of diabetes. Investigators reported a reduction of systolic BP to <120
mm Hg (vs < 140 mm Hg) was associated with a lower incidence of cardiovascular-events, -
mortality, and all-cause mortality for both black and nonblack patients. The extent to which
systolic BP control of <120 mm Hg is achieved in VA is unknown. Special focus is needed for
the VA group at highest risk for uncontrolled BP, black Veterans. This group is expected to grow
at least 3% from 11% of Veterans in 2014 to 14% by 2034. The goals of this project are: Aim 1.
To examine, one year following Veterans’ incident hypertension diagnosis, patient level
predictors of (1) use of guideline-recommended medications and (2) BP control among
Veterans and to describe how the effect of these predictors varies by race; Aim 2. To identify
provider and facility level predictors of use of guideline-recommended medications and BP
control among Veterans with incident hypertension and to describe how the effect of these
predictors varies by race using mixed-methods; and Aim 3. To develop and pilot test a
provider/team focused informatics strategy to facilitate hypertension control with enhanced
features for racial minority Veterans. Aims 1-2 involve a longitudinal retrospective cohort study
of black and white Veterans from VA facilities nationwide with incident hypertension 2007-2012
and examining outcomes of (1) prescriptions for JNC7 guideline-recommended medications and
(2) controlled hypertension 1-year after incident hypertension diagnosis. Using regression
models, patient- (Aim 1), provider- and facility-level (Aim 2) variables will be identified that are
predictors for not receiving of guideline-recommended medications for hypertension and/or lack
of BP control at 1-year of follow-up. Aims 1-2 further examine how these predictors vary by
race. The qualitative analysis for Aim 2 will include chart review using natural language
processing methods and a total of 36 telephone interviews with Patient Aligned Care Team
(PACT) providers from 4 VA facilities ...

## Key facts

- **NIH application ID:** 10295193
- **Project number:** 5IK2HX002609-05
- **Recipient organization:** VA SALT LAKE CITY HEALTHCARE SYSTEM
- **Principal Investigator:** April F Mohanty
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-02-01 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10295193

## Citation

> US National Institutes of Health, RePORTER application 10295193, Race/ethnic differences in guideline recommended hypertension medications in VHA (5IK2HX002609-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10295193. Licensed CC0.

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