ATLANTA — African Americans are less likely than members of other races to persist in combination antihypertensive therapy, according to a retrospective analysis of medical and pharmacy claims for Medicaid patients in Maryland who were prescribed the combination of an ACE inhibitor and a calcium channel blocker or an ACE inhibitor and a hydrochlorothiazide diuretic during 2002–2004.
Of the 1,701 total patients, 17.5% were persistent in their use of the medication and 82.5% discontinued. Of the 1,137 African Americans, 15.5% were persistent, compared with 21.2% of the 448 whites and 23.3% of the 116 members of other races, said Fadia T. Shaya, Ph.D., in a poster presentation at a meeting sponsored by the International Society on Hypertension in Blacks and cosponsored by the American Society of Hypertension.
After adjustment for age, gender, and comorbidities, African Americans were 21% more likely to discontinue their therapy than were members of other races. The relationship was statistically significant when patients used a fixed-dose combination in a single pill and when they used a free combination regimen with two concurrent pills, said Dr. Shaya of the University of Maryland, Baltimore. After adjustment for all other covariates, other factors that were significant predictors of nonpersistent behav- ior included patients under age 40 years and those with a higher comorbidity index.