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April 3, 2026Journal of Racial and Ethnic Health Disparities0 citationsOpen Access

Community Clinic Blood Pressure and BMI Control in Black Americans with Hypertension: A Retrospective Chart Review

TATracie L AugustaAMAnnapoorna MaryAOAngela Oigbokie

Key Result

Black American adults with hypertension receiving community clinic care had a mean systolic blood pressure of 140.23 mm Hg and BMI of 33.12 kg/m², significantly exceeding guideline targets.

Key Points

  • This study aims to compare blood pressure and BMI control in Black Americans with hypertension receiving care in community settings.
  • Retrospective chart review of 100 Black adults with hypertension from electronic health records
  • Comparison of clinical characteristics between cardiovascular clinics and primary care clinics
  • Statistical analysis included independent and one-sample t tests and effect size assessment using Cohen's D
  • Mean systolic blood pressure was 140.23 mm Hg, diastolic blood pressure was 83.84 mm Hg, and mean BMI was 33.12 kg/m²
  • 46% of the sample had stage 2 hypertension and 65% were classified as obese
  • Both blood pressure and BMI control were above recommended targets with significant effect sizes indicating excess BMI

Study Design

Type

Observational (n=100)

Multicenter

Yes

Structured PICO

Does care setting (primary care vs. cardiovascular clinic) affect blood pressure and BMI control in Black Americans with hypertension?

P
Population
100 Black American adults (age ≥18 years) with an active hypertension diagnosis receiving pharmacologic treatment, mean age 60.6 years, 54% female, receiving community-based care in the US. Key inclusion: self-identified as Black or African American, documented HTN diagnosis, and at least one clinic visit with BP and BMI documented within the 12-month study period.
I
Intervention
Care at a community primary care clinic (PCC)
C
Comparator
Care at a community cardiovascular clinic (CVC)
O
Outcome
Mean systolic blood pressure (SBP), diastolic blood pressure (DBP), and body mass index (BMI) compared with guideline-based targets (<130/80 mmHg and 24.9 kg/m²) over a 12-month periodsurrogate

Blood pressure and BMI control remain significantly suboptimal among insured Black Americans with hypertension in both primary and specialty community clinics, highlighting the need for culturally tailored, multilevel interventions.

Main Result

Effect estimate: Cohen d = 0.18

Absolute Event Rate: 141.79% vs 138.67%

p-value: p=0.368

Limitations

  • Retrospective observational design cannot establish causality
  • Small sample size (N=100) from only two clinics in a single city limits generalizability
  • Lack of adjustment for potential confounders like socioeconomic factors and medication adherence
  • Potential selection bias by only including patients with at least one documented visit
  • Reliance on routine clinic BP measurements without ambulatory or home monitoring confirmation
  • Retrospective observational chart review, preventing causal inferences
  • Small sample size (N=100)
  • Drawn from only two clinics in a single city, limiting generalizability
  • Did not fully adjust for all potential confounders, including detailed socioeconomic factors and medication adherence

Abstract

Comparing clinical characteristics and visit patterns between cardiovascular clinics (CVC) and primary care clinics (PCC) among Black Americans with hypertension (HTN) receiving community-based care. This retrospective chart review examined the electronic health records of 100 Black adults with HTN (50 CVC, 50 PCC). Data include 12-month visit counts, blood pressure (BP), body mass index (BMI), and antihypertensive medications. Independent samples t tests compared mean systolic BP, diastolic BP, BMI, and visit counts by sex and clinic type; one-sample t tests compared mean SBP, DBP, and BMI with guideline-based targets. Effect sizes were estimated using Cohen’s D. The sample included 54 women and 46 men (mean age, 60.6 years). Women had more visits than men (mean SD, 2.93 1.26 vs. 2.39 1.13; P = .028; Cohen d = 0.45), and PCC patients had more visits than CVC patients (3.08 1.19 vs. 2.28 1.13; P = .001; Cohen d = 0.70). Mean SBP was 140.23 mm Hg, DBP 83.84 mm Hg, and BMI 33.12 kg/m²; 46% had stage 2 HTN and 65% were obese. All three measures were significantly above targets of 130 mm Hg, 80 mm Hg, and 24.9 kg/m² (all P < .01; Cohen d = 0.59, 0.29, and 1.09, respectively). SBP and DBP did not differ significantly by sex or clinic type (Cohen d ≤ 0.26), whereas BMI was higher in PCC than CVC patients (35.66 vs. 30.57 kg/m²; P = .001; Cohen d = 0.71). BP and BMI control were suboptimal despite high insurance coverage and regular clinic visits, with large effect sizes for excess BMI, underscoring the need for targeted, culturally responsive interventions in both primary and specialty care.

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Cite This Study

Augusta et al. (2026) conducted an observational in Hypertension (n=100). Cardiovascular clinic care vs. Primary care clinic care was evaluated on Mean systolic blood pressure (mmHg) (Cohen d = 0.18, p=0.368). Black American adults with hypertension receiving community clinic care had a mean systolic blood pressure of 140.23 mm Hg and BMI of 33.12 kg/m², significantly exceeding guideline targets.

synapsesocial.com/papers/69cf5cd15a333a821460a58fhttps://doi.org/10.1007/s40615-026-02961-9
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Improving Hypertension Control in Primary Care With the Measure Accurately, Act Rapidly, and Partner With Patients Protocol2018 · 106 citations
  2. 2‘They should walk with you’: the perspectives of African Americans living with hypertension and their family members on disease self-management2022 · 17 citations
  3. 3Improving Blood Pressure Among African Americans With Hypertension Using a Mobile Health Approach (the MI-BP App): Protocol for a Randomized Controlled Trial2018 · 25 citations
  4. 4Uncontrolled hypertension increases risk of all-cause and cardiovascular disease mortality in US adults: the NHANES III Linked Mortality Study2018 · 360 citations
  5. 5Potential Cardiovascular Disease Events Prevented with Adoption of the 2017 American College of Cardiology/American Heart Association Blood Pressure Guideline2018 · 64 citations