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INTRODUCTION: Given the increasing impact of the healthcare cost of hypertension on the economy, understanding the control of high blood pressure is warranted, particularly as it pertains to racial/ethnic disparities in hypertension control. OBJECTIVE: To understand the relationship between hypertension control and racial/ethnic concordance, we investigated whether the racial/ethnic concordance between a patient’s race/ethnicity and that of the individual’s provider is a predictor of high blood pressure control. METHODS: Data was collected for 612,524 patients from Kaiser Permanente Southern California who were at least 18 year old and received a diagnosis of hypertension between January 1, 2016 and December 31, 2019. A multiple regression analysis was carried out to assess the correlation between hypertension control and patient-provider concordance. RESULTS: The independent variables proxying for patient-provider relationship are positive and statistically significant at the 5% level. Out of the 3 types of concordance, language has the highest standardized estimate, followed by gender and race. DISCUSSION: We found correlations between racial/ethnic patient-provider concordance and hypertension control. Consistent with previous studies, we found that Asian patients experience more time in hypertension control. By contrast, Black and Hispanic patients have less time in hypertension control. Having the same primary care provider for a longer span of time is also positively correlated with length of hypertension control. CONCLUSION: Correlation between racial/ethnic concordance, length of time under the primary provider’s care, and length of time spent in hypertension control suggests that the patient-provider relationship remains a critical component of health outcomes.

Mixed findings with regard to cardiovascular reactivity (CVR) and posttraumatic stress disorder (PTSD) have suggested a need to further explore the nature of this relationship and factors that might explain differences in reactivity across and within samples. In the present study, the severity of PTSD symptoms was investigated in relation to CVR among young women. In addition, we examined whether severity within PTSD symptom clusters and level of dissociative symptoms were related to CVR. Heart rate, systolic and diastolic blood pressure, cardiac output (CO) and total peripheral resistance (TPR) reactivity in response to an oral speaking task were assessed for 58 young trauma-exposed civilian women with varying levels of PTSD symptomatology (from no symptoms to high severity of PTSD). The PTSD severity sub-scores for the DSM-V symptom clusters and total PTSD severity were based on structured interview (Clinician Administered PTSD Scale), and dissociative symptoms were assessed using the Dissociative Experiences Scale. Severity of total PTSD symptoms was associated with greater CO reactivity (r = .48, p < .01) and lower TPR reactivity (r = −.50, p < .01). Significant associations were not observed for heart rate or blood pressure. Results did not vary according to severity of symptoms within PTSD symptom cluster, with correlations for CO reactivity ranging from .40 to .49 and correlations for TPR reactivity ranging from −.40 to −.50 within symptom clusters. Dissociative symptoms were not significantly correlated with the CVR measures. Results partially supported the expectation that PTSD severity is one factor that would be associated with CVR, and suggest that reactivity for the underlying components of blood pressure (CO and TPR) provide additional information in probing stress reactivity in PTSD.