Abstract WP253: Prevalence of Undiagnosed and Uncontrolled Hypertension Among Low-Wage Workers in North Carolina With Elevated Stroke Risk

Abstract

Introduction: Compared to the rest of the United States, North Carolina has an elevated stroke mortality rate. Risk factors, including uncontrolled hypertension (HTN), associated with disparities in stroke outcomes are also prevalent in North Carolina. We sought to determine the prevalence of undiagnosed and uncontrolled HTN among a sample of low-wage workers with elevated stroke risk. Methods: Between February 2021 and June 2023, we partnered with 35 business to provide worksite-based health screenings to rural, low-wage workers. Demographic information and a brief medical history were collected. A physical assessment included automated blood pressure measurement. Risk of stroke was assessed using the CHA 2 DS 2 -VASc. Results: A total of 930 screened individuals (52.5% Black) are included in this report. Among the 488 Black participants screened, 29.1 percent (n=142) had a CHA 2 DS 2 -VASc score ≥2. In comparison, less than 20 percent (n=79, 17.9%) of the 442 White participants had an elevated stroke risk (Figure 1). Of the 221 participants with a CHA 2 DS 2 -VASc score ≥2, stage 1 HTN (systolic blood pressure (SBP) = 130-139) and stage 2 HTN (SBP ≥ 140) was found among 19.5 and 52 percent of participants, respectively. We identified previously undiagnosed HTN among 6.3 percent of Black participants and 15.2 percent of White participants. In addition, over 60 percent of participants (Black = 62.7%, White = 60.8%) had been previously diagnosed with HTN, but screening results indicated their HTN was not well controlled. Conclusions: The prevalence of elevated stroke risk was 11.2 percent greater among Black participants compared to White participants. Using a worksite-based approach to health screening, we found high rates of undiagnosed and uncontrolled HTN among both Black and White participants with elevated stroke risk. This novel approach to care delivery facilitates screening among individuals who may otherwise underutilize or avoid engagement with the healthcare system.