Abstract 18650: Differences in Hypertension Prevalence, Awareness, and Treatment Between Sexual Minority and Heterosexual Adults in the All of Us Research Program

Abstract

Introduction: Hypertension accounts for approximately half of cardiovascular disease morbidity and mortality globally. There is growing evidence that younger sexual minority (e.g., gay and bisexual) men and bisexual women report a higher prevalence of hypertension than their heterosexual counterparts. However, there is limited evidence on differences in hypertension prevalence, awareness, and treatment among sexual minority middle-aged and older adults. Therefore, we sought to examine differences in hypertension prevalence, awareness and treatment between sexual minority and heterosexual middle-aged and older adults. Hypothesis: Compared to heterosexual adults, sexual minority participants will: 1) have a higher prevalence of hypertension, 2) be less likely to be aware of their hypertension, and 3) be less likely to obtain hypertension treatment. Methods: We analyzed questionnaire, physical examination, and diagnostic data from the All of Us Research Program. We used sex-stratified multivariate logistic regression models to examine sexual identity differences in objective hypertension (i.e., a systolic blood pressure ≥ 130 and/or a diastolic blood pressure ≥ 80), hypertension awareness, and hypertension treatment among adults. Results: The sample included 53,582 participants with a mean age of 56.3 years (±16.4); 66% were female and 78% were non-Hispanic White. Among men who met objective criteria for hypertension, bisexual men were less likely to report they were unaware they had hypertension compared to heterosexual men (AOR = 0.67, 95% CI = 0.52-0.88). There were no differences in hypertension prevalence or hypertension treatment between sexual minority and heterosexual adults. Conclusions: This is the first study to use data from the All of Us Research Program to examine disparities in hypertension prevalence, treatment, and awareness among sexual minority middle-aged and older adults. We found few differences between sexual minority and heterosexual participants, which contradicts prior work that has largely focused on younger adults. Findings suggest that researchers should investigate factors that contribute to the narrowing of hypertension disparities among sexual minority adults as they age.