Abstract 437: Racial/Ethnic Differences in Cardiovascular Disease Outcomes in Hypertensive Patients

Abstract

Background: Higher rates of CVD have been found in Mexicans and some Asian American subgroups as well as African Americans. However, little is known about the association between HTN, a main risk factor of CVD, and CVD among rapidly growing minority groups. Our study aims to identify racial/ethnic differences in CVD outcomes in HTN patients across Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese), Mexican, African American, and non-Hispanic White (NHW) in a large, mixed payer ambulatory care setting in northern California. Study Design: We examined electronic health records of patients age 18 years or older with at least one primary care visit from 2008-2012. CVD was defined by ICD-9 codes while HTN was defined by ICD-9 codes, antihypertensive medication, or two or more abnormal blood pressure readings (>140/90mm Hg). We estimated the rate of CVD incidence among HTN patients. Follow-up period was six years on average. Results: African Americans had the highest prevalence of HTN (51%, 2,715 out of 5,328), followed by NHWs (35%, 96,965 out of 276,133), Mexicans (34%, 3,867 out of 11,532), and Asian Americans (24%, 29,872 out of 124,139). Among these HTN patients, 9% (11,667 out of 133,419) developed CVD by the end of year 2012. HTN patients with CVD were more likely to be older, male, smoker and have a higher BMI. There was no significant difference in baseline BP levels. Compared to NHWs, both African American (OR=1.84, CI: 1.61-2.10) and Mexican HTN patients (OR=1.28, CI: 1.12-1.46) were at a higher risk of developing CVD after adjusting for age and gender, while Asian Americans were at a lower risk (OR: 0.81, CI: 0.79-0.86). Racial/ethnic differences also presented across the Asian American subgroups with Filipino and Asian Indian HTN patients at an elevated risk of developing CVD compared to other Asian American subgroups. Conclusions: Among HTN patients, there is heterogeneity across R/E minority groups in their risk of developing CVD. It might be differential utilization pattern such that Mexicans, Filipinos, and Asian Indian are likely to receive HTN treatment at more severe stage. Further studies are needed to better understand the pathways of CVD development among HTN patients of different race/ethnicity.