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

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.