Cardiovascular Health Practices Among Black Patients in an Urban Underserved Clinic

Background: An understanding of cardiovascular health practices among black patients can provide more comprehensive patient-centered care and reduce health disparities. We studied home blood pressure monitoring in our underserved patient population to determine feasibility of providing automatic blood pressure monitors to our hypertensive patients. We believed that if we provided blood pressure monitors for home use, our patients would increase home blood pressure assessments, frequency of blood pressure assessments, and provide more data on managing their hypertension. Methods: Forty patients were selected based on their individually scheduled clinic appointments and were randomized to the experimental arm or the control arm. Patients in the experimental arm of the study received an automatic blood pressure monitor for the duration of the study, while the control group received their automatic blood pressure monitor at the end of the study period. All participants received evidence-based patient education upon enrollment in addition to phone calls to collect blood pressure readings every two weeks. After six months, patients completed an exit interview and survey to determine the effects of the study on enrollee health practices. Results: Of the 40 people enrolled, 13 participants completed the study. Of those who completed, 87% of the experimental group checked their blood pressure more often outside of the healthcare setting compared to 60% of the control group. There was no increase in the control group's pre-survey blood pressure monitoring metrics but a 50 percentage point increase in the experimental group's blood pressure monitoring metrics. Telephone data demonstrated that participants who received an automatic blood pressure monitor for home use were more than three times more likely to check their blood pressure outside of the healthcare setting than those who did not have a home monitor. Conclusions: Home accessible automatic blood pressure monitoring can increase frequency of blood pressure assessment among black patients.