Abstract 14121: Trends In Awareness, Use Of Medication, And Blood Pressure Control By Race And Ethnicity Among U.S. Adults With Hypertension: A 20-year National Health And Nutrition Examination Survey Analysis, 1999-2018

Abstract

Introduction: Black and Hispanic adults have poorer hypertension control compared with White adults in the US. Less is known about the country’s progress in eliminating disparities in awareness and treatment of hypertension and whether these differences explain the difference in hypertension control. Methods: We assessed 20-year trends in racial/ethnic differences in awareness, use of medication, and whether these differences help explain racial/ethnic difference in blood pressure (BP) control in the US population, using data from 59,204 hypertensive adults enrolled in the National Health and Nutrition Examination Survey (1999-2018). Results: For all 3 racial groups (White, Black, and Hispanic), hypertension awareness, treatment, and control rates increased between 1999-2013, and then declined between 2014-2018. Although Black adults had a lower BP control rate (odds ratio: 0.77 [0.70-0.85]) compared with White adults, they had a higher awareness rate (1.30 [1.13-1.46]), a similar overall treatment rate (1.07 [0.94-1.19]) and received more intensive antihypertensive therapy (OR for combination therapy 1.32 [1.19-1.45]). Hispanic adults had a significantly lower BP control rate (0.68 [0.59-0.77]), awareness rate (0.76 [0.65-0.85]), overall treatment rate (0.65 [0.55-0.74]) and received less intensive therapy compared with Black and White adults. From 1999-2018, the racial/ethnic differences in awareness, treatment, and BP control persisted and were more pronounced among younger (<60 years of age), male, and lower income adults. Lower awareness and treatment were associated with lower BP control in Hispanics, but not in Blacks. Conclusions: Although Blacks had higher level of awareness and received more intensive antihypertensive therapy, Hispanics were less aware and treated than White. Racial/ethnic differences in awareness and treatment partially explain difference in hypertension control for Hispanics, but not for Blacks.