Abstract

Introduction: Hypertension risk increases with higher age and body mass index (BMI). We previously found that the prevalence of diagnosed hypertension among Filipino adults is similar to Black adults and higher than White, Chinese, and South Asian adults aged 45-84y. Among young women, the difference between Filipina and Chinese adults was >2-fold. We now examine disparities in hypertension prevalence across the adult lifespan, accounting for differences in weight status. Methods: This cross-sectional study used electronic health record data for 1,018,159 non-Hispanic White (White), 146,517 Black, 348,715 Hispanic, 128,124 Filipino, 126,321 Chinese, and 80,723 South Asian adults aged 30-79 who were members of a Northern California health plan in 2016. Hypertension prevalence (ICD 9/10 diagnosis in 2016) was examined by race/ethnicity and sex for ages 30-39, 40-49, 50-59, 60-69, 70-79y. Poisson regression was used to estimate prevalence ratios (aPRs) for hypertension compared to White adults in each age decade, adjusting for age, English language, current smoking, and BMI category (underweight, healthy weight, overweight, obesity class 1, 2, 3). Lower BMI thresholds were used for Asian adults. Results: Across all age decades, Filipino adults had a prevalence of hypertension similar to Black adults and higher than White, Chinese, and South Asian adults. In each age decade, the Filipino:White aPRs approached or exceeded the Black:White aPRs and were much higher than South Asian:White and Chinese:White aPRs (Figure). Differences in hypertension risk were greatest for those aged 30-59y. Conclusions: Filipino adults, similar to Black adults, had earlier onset and higher prevalence of hypertension than White, Chinese, and South Asian adults across 5 age decades, a disparity that persisted after adjusting for weight status, smoking, and language. These results support the need for earlier and more aggressive blood pressure screening in high-risk populations.

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