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When the attending physician does not use the power to access expert
opinion so as to achieve better control of the patient's blood
pressure (BP) this amounts to concealment of power. In a cross sectional
survey of management of hypertension, one nationwide survey documented
that only 59.7% of treated whites and 48.9% of treated blacks acheived
goal blood pressures, and that this difference was significant (p <
0.001) notwithstanding the fact that, compared with whites, blacks were
more likely to have hypertension and to be aware of it(1). What the
authors did not address was the question of whether or not the attending
physicians were less likely to refer suboptimally treated patients to
specialists in the management of hypertension.
(1) Hertz RP., Unger AN., Cornell A., Saunders E
Racial disparities in hypertension prevalence, awareness, and management
Arch Intern Med 2005:165:2098-2104