Abstract 11619: Cost of Treatment is a Barrier to Hypertension Control in Puerto Rican Adults in Massachusetts

Abstract

Introduction: Little is known about hypertension (HTN) control among Puerto Ricans living on the U.S mainland. We examined awareness, treatment and control of HTN among Puerto Rican adults living in the Boston area to determine whether cost of treatment is a barrier to control. Methods: We used baseline data (2004-2009) from the Boston Puerto Rican Health Study, a longitudinal study of approximately 1500 Puerto Rican adults. Blood pressure was based on the mean of up to 4 determinations. Awareness, treatment and control among all participants, and those being treated, were defined as in the National Health and Nutrition Examination Survey (NHANES). Perceived cost as a barrier to treatment was based on response to a single item. The association of cost with HTN control was tested in multivariable logistic models, adjusting for covariates suggested in the literature, including BMI, serum, creatinine, diabetes, age, alcohol use, and nonsteroidal anti-inflammatory drugs (NSAIDs) use. Results: Participants with HTN (n= 941) had mean age 58.6 + 7.6 years, and 70% were female. Among these, 83.6%, were aware of their HTN, 77.8% were treated, and 37.0% were controlled. Among those being treated, 47.5% were controlled. Seventeen percent of those with HTN reported cost as barrier to treatment. Among those reporting cost as barrier, 27.6% were controlled compared to 38.9% of those with no cost barrier (p<0.01). Among treated HTN patients, 36.4% of those reporting cost as a barrier to treatment were controlled compared to 49.5% of those with no cost barrier (p<0.01). The odds ratio (95%Cl) for control was 0.63 (0.43, 0.93) for cost as a barrier among all participants with HTN, and 0.60 (0.39, 0.91) among those treated. Conclusion: HTN control in Boston-area Puerto Ricans is lower than reported in NHANES for the general US population. Cost of treatment appears to be an important barrier to achieving control.