Abstract MP13: Disparities in Home Blood Pressure Monitoring Among Adults Diagnosed With Hypertension Receiving Primary Care in a Large Academic Health System

Abstract

Background: Uncontrolled hypertension (HTN) remains a major global public health challenge. Home blood pressure monitoring (HBPM) in combination with co-interventions is an effective strategy for managing and controlling HTN. Our objective was to examine disparities in HBPM among patients diagnosed with HTN in an academic health system. Methods: Using a cross-sectional design, we invited patients with an HTN diagnosis in their electronic health record (EHR) and primary care visit in the past 12 months to complete an anonymous online survey through the EHR patient portal. We used logistic regression to examine disparities in self-reported home blood pressure (BP) monitor ownership (yes/no), frequency of HBPM in the past month (< once or ≥ once), and sharing of BP readings with healthcare provider in the past 6 months (yes/no). Results: We recruited 4,181 adult patients; 48%, ≥ 65 years old; 55%, female; 63%, White; 28%, Black; and 4% Asian adults. About 86% owned a home BP monitor. Those who self-identified as Black race (odds ratio [OR] = 0.73, 95% confidence interval [CI]: 0.58-0.91), other race (odds ratio [OR] = 0.62, 95% confidence interval [CI]: 0.41-0.95) and who were unemployed (OR = 0.54, 0.42-0.70) had lower odds of having a home BP monitor than patients who were White adults and were employed, respectively. Adults aged ≥ 65 years had lower odds of checking BP at home ≥ once a month than their counterparts who were < 65 years old (OR = 0.75, 0.62-0.91). Although women (OR = 1.51, 1.29-1.77) and adults who earned > $100,000 (OR = 1.42, 1.11-1.81) were more likely to check their BP in the previous month than men and those earned < $50,000, they (Female: OR = 0.83, 0.71-0.97; Income > $100,000: OR = 0.77, 0.60-0.99) were less likely to share home BP readings with healthcare provider. Conclusions: We observed substantial disparities in HBPM among adults with HTN. Although HBPM has the potential to advance equity in HTN control, factors such as age, race, and socioeconomic status should be considered in the design and implementation of such programs.