Disparities In Hypertension Prevalence Research Articles

Hypertension Prevalence and Control Among People With and Without HIV - United States, 2022.

People with HIV (PWH) have higher rates of cardiovascular disease than people without HIV. However, limited information exists about hypertension prevalence and associated risk factors in PWH. This cross-sectional study included adult patients in the 2022 IQVIATM Ambulatory Electronic Medical Record - US data. HIV was identified based on ≥2 HIV diagnosis codes or a positive HIV test. Hypertension was identified by diagnosis codes, ≥2 blood pressure (BP) readings ≥130/80 mmHg, or an antihypertensive medication prescription. Among those with hypertension, control was defined as most recent BP <130/80 mmHg. Logistic models using marginal standardization method were used to estimate adjusted prevalence ratios (aPR) of hypertension and hypertension control among all patients and PWH specifically, controlling for covariates. Of 7,533,379 patients, 19,102 (0.3%) had HIV. PWH had higher hypertension prevalence (66% vs 54%, aPR:1.14, 95% CI: 1.13-1.15) compared with people without HIV. Among persons with hypertension, PWH were more likely to have controlled hypertension (aPR: 1.10, 95% CI: 1.07-1.13) compared with people without HIV. Among PWH, those from the South were more likely to have hypertension (aPR: 1.07, 95% CI: 1.02-1.12) than PWH from the Northeast, while Black PWH were less likely to have controlled hypertension (aPR: 0.72, 95% CI: 0.67-0.77) than White PWH. PWH were more likely to have hypertension than people without HIV. Geographic and racial disparities in hypertension prevalence and control were observed among PWH. Optimal care for PWH includes comprehensive strategies to screen for, prevent, and manage hypertension.

Disparities in Hypertension Prevalence, Awareness, Treatment, and Control Among Women Living With and Without HIV in the US South.

Hypertension-related diseases are major causes of morbidity among women living with HIV. We evaluated cross-sectional associations of race/ethnicity and HIV infection with hypertension prevalence, awareness, treatment, and control. Among women recruited into Southern sites of the Women's Interagency HIV Study (2013-2015), hypertension was defined as (1) systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg according to clinical guidelines when data were collected, (2) self-report of hypertension, or (3) use of antihypertensive medication. Awareness was defined as self-report of hypertension, and treatment was self-report of any antihypertensive medication use. Blood pressure control was defined as <140/90 mm Hg at baseline. Prevalence ratios for each hypertension outcome were estimated through Poisson regression models with robust variance estimators adjusted for sociodemographic, behavioral, and clinical risk factors. Among 712 women, 56% had hypertension and 83% were aware of their diagnosis. Of those aware, 83% were using antihypertensive medication, and 63% of those treated had controlled hypertension. In adjusted analyses, non-Hispanic White and Hispanic women had 31% and 48% lower prevalence of hypertension than non-Hispanic Black women, respectively. Women living with HIV who had hypertension were 19% (P = .04) more likely to be taking antihypertension medication when compared with women living without HIV. In this study population of women living with and without HIV in the US South, the prevalence of hypertension was lowest among Hispanic women and highest among non-Hispanic Black women. Despite similar hypertension prevalence, women living with HIV were more likely to be taking antihypertensive medication when compared with women living without HIV.

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

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.

Educational Disparities in Hypertension Prevalence and Blood Pressure Percentiles in the Health and Retirement Study.

Hypertension and uncontrolled high blood pressure (BP) are more prevalent among less-educated older adults than those with more schooling. However, these dichotomous indicators may fail to fully characterize educational disparities in BP, a continuous measure that predicts morbidity and mortality across much of its range. This study therefore focuses on the distribution of BP, assessing educational disparities across BP percentiles in addition to disparities in hypertension and uncontrolled BP. Data are from the 2014-2016 Health and Retirement Study, a nationally representative survey of older U.S. adults (n = 14,498, ages 51-89). To examine associations between education, hypertension, and uncontrolled BP, I estimate linear probability models. To assess relationships between education and BP, I fit linear and unconditional quantile regression models. Less-educated older adults are not only more likely to have hypertension and uncontrolled BP than those with more schooling, they also have higher systolic BP across nearly the entire BP distribution. Educational disparities in systolic BP increase in magnitude across BP percentiles and are largest at the highest levels of BP. This pattern is observed for those with and without diagnosed hypertension, is robust to early-life confounders, and is only partially explained by socioeconomic and health-related circumstances in adulthood. Among older U.S. adults, the distribution of BP is compressed at lower, healthier levels for those with more education, and skewed toward the highest, most harmful levels among those with less education. Educational inequities in hypertension awareness and treatment efficacy may underlie these patterns. Implications for fundamental cause theory are discussed.

Race Disparities in Hypertension Prevalence Among Older Men.

This study aimed to examine whether hypertension prevalence varies by race/ethnicity and within age groups in a nationally representative sample of men in the United States. Hypertension was defined as blood pressure (BP) readings of 140 mm Hg and higher for systolic BP, 90 mm Hg and higher for diastolic BP, or self-reports of taking medication for hypertension. Modified Poisson models estimated prevalence ratios (PRs) and 95% confidence intervals (CI) for race and age group associations with hypertension. The prevalence of hypertension was 38% overall and 46% of the men were aged 50 and older. Analyses that focused on older men (50 years of age or older) found that non-Hispanic Black men had a higher prevalence of hypertension (PR = 1.28, 95% CI: 1.19 - 1.37) compared to non-Hispanic White men. We suggest future research utilize life course perspectives to better identify which cumulative experiences impact hypertension disparities.

RAG-MENA-2: CV RISK PROFILE AND LIFESTYLE PATTERN IN THE MENA

There are large and widening global disparities in hypertension prevalence and control in the Mena region. Almost 40% of adults in the region are either overweight or obese with high rates of childhood obesity. More than a third of the adult population in these countries having either hypertension or diabetes or both. Age at onset of CVD is lower and HTN prevalence is increasing.The prevalence of hypertension in Lebanon increased from 23.1% as reported in 2005 to 35% in 2015 and 37% in 2019. 64.1% of them were aware of it, and only 62.6% of treated participants had a controlled BP. Since only around half of patients with hypertension in Lebanon are aware of their disease as reported previously, screening for HTN and increasing awareness are of tremendous importance for the population in Lebanon. Collaborative efforts from national and international stakeholders are urgently needed to combat the emerging hypertension burden in low- and middle-income countries. Stakeholders should promote blood pressure screening, access to affordable healthcare and antihypertensive medications, and adherence to antihypertensive treatment to improve hypertension control in low- and middle-income countries. Implementation of innovative, cost-effective, and sustainable programs for hypertension prevention and control should be a public health priority for these countries.

Abstract 9990: Hypertension Risk Differs by Asian Ethnicity Across the Adult Lifespan

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 &gt;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.

Urban–rural disparities in hypertension prevalence, awareness, treatment, and control among Chinese middle-aged and older adults from 2011 to 2015: a repeated cross-sectional study

BackgroundChina has experienced a continuing increase in hypertension prevalence over the past few decades, especially in rural areas. The paper aims to examine the variation of urban–rural disparities in hypertension prevalence, awareness, treatment, and control among Chinese middle-aged and older adults between 2011 and 2015.MethodsOur team extracted data from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey of residents aged 45 years and older. In this study, we used the 2011 wave and the 2015 wave of CHARLS. We calculated crude rates and age-adjusted rates of hypertension prevalence, awareness, treatment, and control for the general, urban, and rural populations in each wave and performed chi-square tests to examine urban–rural disparities. We used logistic regression to further confirm these disparities by controlling confounding factors in each wave. We then used generalized estimating equation (GEE) to further examine whether urban–rural disparities changed between 2011 and 2015.ResultsWe included 11,129 records in the 2011 wave and 8916 records in the 2015 wave in this study. The mean age was 59.0 years and 5359 (48.2%) participants were male in the 2011 wave. Age-adjusted hypertension prevalence, awareness, treatment, control, and control among treated in the total population were 38.5%, 70.6%, 59.2%, 27.4%, and 46.4% in 2015. Urban–rural disparities in the indicators mentioned above were 5.7%, 13.4%, 15.3%, 9.4% and 5.6% in 2011; which decreased to 4.8%, 2.7%, 5.2%, 4.9% and 3.8% in 2015. Urban–rural disparities in prevalence, awareness and treatment were statistically significant in 2011 but not significant in 2015 adjusted for confounding factors, yet control disparities were statistically significant in both waves. Finally, urban–rural disparities in awareness and treatment had narrowed from 2011 to 2015.ConclusionsAwareness, treatment, and control rates were sub-optimal among both urban and rural adults. Prevention and management of hypertension among both urban and rural adults should be further strengthened. Awareness and treatment increased more rapidly among rural adults, indicating some achievement had been made in enhancing the healthcare system in rural areas. More efforts are needed in attaining urban–rural equity of healthcare services.

Socioeconomic risk factors of hypertension and blood pressure among persons aged 15-49 in Nepal: a cross-sectional study.

ObjectivesThis study estimated the prevalence of hypertension, in accordance with the American College of Cardiology and American Heart Association’s 2017 guidelines, and examined the association between various socioeconomic factors and systolic blood pressure (SBP), diastolic blood pressure (DBP) and hypertension.Setting and designWe used nationally representative data from the 2016 Nepal Demographic and Health Survey. Multivariate analysis was used to study the association of hypertension with socioeconomic factors: logistic regression was used for hypertension and linear regression was used for DBP and SBP.ParticipantsOur sample consisted of 9827 adults between the ages of 15 and 49 years.ResultsThe prevalence of hypertension was 36%. The mean DBP and SBP were 76.4 and 111.5, respectively. Janjatis (adjusted OR (AOR): 1.34, CI: 1.12 to 1.59), Other Terai castes (AOR: 1.38, CI: 1.03 to 1.84), Muslim and other ethnicities (AOR: 1.64, CI: 1.15 to 2.33) and Dalits (AOR: 1.26, CI: 1.00 to 1.58) had higher odds of hypertension. Individuals employed in professional, technical and managerial professions collectively (AOR: 1.62; CI: 1.18 to 2.21) also had higher odds of hypertension. Moderately food insecure household had lower odds of hypertension (AOR: 0.84; CI: 0.72 to 0.99) compared with households with no issue of food insecurity. Results were similar for SBP and DBP. When stratified by sex, there were differences mainly in terms of occupation and ethnicity.ConclusionThere are substantial disparities in hypertension prevalence in Nepal. These disparities extend across ethnic groups, occupational status and food security status. Differences also persist across different provinces. As hypertension continues to be increasingly more significant, more research is needed to better understand the disparities and gradients that exist across various socioeconomic factors.

Racial/Ethnic Disparities in Hypertension Prevalence, Awareness, Treatment, and Control in the United States, 2013 to 2018.

[Figure: see text].

Associations of biogeographic ancestry with hypertension traits.

Ethnic disparities in hypertension prevalence are well documented, though the influence of genetic ancestry is unclear. The aim of this study was to evaluate associations of geographic genetic ancestry with hypertension and underlying blood pressure traits. We tested genetically inferred ancestry proportions from five 1000 Genomes reference populations (GBR, PEL, YRI, CHB, and LWK) for association with four continuous blood pressure (BP) traits (SBP, DBP, PP, MAP) and the dichotomous outcomes hypertension and apparent treatment-resistant hypertension in 220 495 European American, 59 927 African American, and 21 273 Hispanic American individuals from the Million Veteran Program. Ethnicity stratified results were meta-analyzed to report effect estimates per 10% difference for a given ancestry proportion in all samples. Percentage GBR was negatively associated with BP (P = 2.13 × 10-19, 7.92 × 10-8, 4.41 × 10-11, and 3.57 × 10-13 for SBP, DBP, PP, and MAP, respectively; coefficient range -0.10 to -0.21 mmHg per 10% increase in ancestry proportion) and was protective against hypertension [P = 2.59 × 10-5, odds ratio (OR) = 0.98] relative to other ancestries. YRI percentage was positively associated with BP (P = 1.63 × 10-23, 1.94 × 10-26, 0.012, and 3.26 × 10-29 for SBP, DBP, PP, and MAP, respectively; coefficient range 0.06-0.32 mmHg per 10% increase in ancestry proportion) and was positively associated with hypertension risk (P = 3.10 × 10-11, OR = 1.04) and apparent treatment-resistant hypertension risk (P = 1.86 × 10-4, OR = 1.04) compared with other ancestries. Percentage PEL was inversely associated with DBP (P = 2.84 × 10-5, beta = -0.11 mmHg per 10% increase in ancestry proportion). These results demonstrate that risk for BP traits varies significantly by genetic ancestry. Our findings provide insight into the geographic origin of genetic factors underlying hypertension risk and establish that a portion of BP trait ethnic disparities are because of genetic differences between ancestries.

Abstract 15858: Efficacy of Hypertension Self-management Classes Among Low-Income Patients of a Federally Qualified Health Center

Introduction: Racial and socioeconomic disparities in hypertension prevalence and treatment have been observed over numerous decades. There is opportunity to close racial disparities by focusing resources on patient education, skill-building, and self-management. Methods: A hypertension-reduction program was established between an academic-affiliated FQHC in the southeast, the American Heart Association, the Centers for Disease Control, and the American College of Preventive Medicine using a multidisciplinary outreach model in the community setting. Participants included 265 high-risk patients from the FQHC with severe hypertension (&gt;160/90 mm HG). Program activities included a weekly class where participants learned about hypertension, were trained to take their blood pressure (BP), and received cuffs to use at home. A prospective pre-post cohort design was used to evaluate this portion of the program. Participants’ attendance at the self-management classes was tracked along with BP measurements at every class attended. Results: Over the program’s first 6 months, 93 of the 265 recruited participants attended at least one of 28 BP management classes. The 29 participants who attended multiple classes achieved an average 19 mm HG reduction in systolic BP ( p =0.004) and an average 14 mm HG reduction in diastolic BP ( p =0.002). Patients who were Black were significantly more likely to attend multiple classes than patients who were Hispanic ( p =0.004). Also, patients who were self-monitoring their BP prior to class attendance were significantly more likely to attend multiple classes than those who were not previously self-monitoring ( p =0.014). Multiple class attendance was also associated with higher baseline BP ( p =0.038 for systolic and p =0.018 for diastolic). Conclusions: Implementation of blood pressure self-management classes showed success in reducing hypertension among many of the high-risk participants. Hispanic patients were much less likely to attend multiple classes, underscoring the need for culturally and linguistically appropriate class content. The low proportion of Hispanic patients previously monitoring their BP points to an opportunity to improve patient awareness about hypertension among Hispanic populations generally.

Racial Disparities in Hypertension Prevalence within US Gentrifying Neighborhoods.

Racial disparities in hypertension remain a persistent public health concern in the US. While several studies report Black–White differences in the health impacts of gentrification, little is known concerning the impact of living in a gentrifying neighborhood on hypertension disparities. Data from the American Community Survey were used to identify gentrifying neighborhoods across the US from 2006 to 2017. Health and demographic data were obtained for non-Hispanic Black and White respondents of the 2014 Medical Expenditure Panel Survey (MEPS) residing in gentrifying neighborhoods. Modified Poisson models were used to determine whether there is a difference in the prevalence of hypertension of individuals by their race/ethnicity for those that live in gentrifying neighborhoods across the US. When compared to Whites living within gentrifying neighborhoods, Blacks living within gentrifying neighborhoods had a similar prevalence of hypertension. The non-existence of Black–White hypertension disparities within US gentrifying neighborhoods underscores the impact of neighborhood environment on race differences in hypertension.

Hypertension and race/ethnicity.

United States racial/ethnic minorities may experience disproportionate hypertension (HTN) morbidity and mortality. This review discusses recent literature regarding the differential impact of HTN, especially among African Americans and Hispanics. Although disparities in HTN prevalence, control, and outcomes persist in racial/ethnic minorities relative to non-Hispanic Whites, racial/ethnic minorities are frequently underrepresented in genetic and clinical studies. Genomics have improved our understanding of HTN, but with no clinically useful application, the role of social determinants of health in HTN disparities is increasingly recognized. Team-based approaches with targeted, multilevel interventions may overcome barriers that uniquely impact racial/ethnic minorities. Despite extensive epidemiological research, racial/ethnic minorities remain at higher risk HTN-related morbidity and mortality. Translational efforts may address the differential impact of HTN in racial/ethnic minorities. This review highlights recent research and concepts related to HTN and race/ethnicity.

Sociodemographic disparities in hypertension prevalence: Results from the first Portuguese National Health Examination Survey

IntroductionCardiovascular disease is an important cause of death and disability worldwide, and hypertension is responsible for at least 45% of all deaths due to heart disease and 51% of deaths due to stroke. This study aimed to estimate and describe the distribution of prevalence, awareness, treatment and control of hypertension in the Portuguese population in 2015. MethodsA national survey using a representative sample of 4911 individuals residing in Portugal and aged between 25 and 74 years was implemented. Trained nurses performed a health interview and a physical examination, including blood pressure measurement (right arm, three measurements at 1-min intervals). The prevalence of hypertension was stratified by gender, age group, marital status, education, occupation and type of residential area. Associations between hypertension prevalence and sociodemographic factors were assessed using bivariate and multivariate Poisson regression. ResultsThe overall hypertension prevalence was 36.0%. The highest rates were observed in males (39.6%), in individuals aged between 65 and 74 years (71.3%), and in those with low levels of education (62.6%) and with no formal occupation (64.5%). Among hypertensive individuals, 69.8% were aware of their condition and 69.4% were under treatment, of whom 71.3% were controlled. Rates of awareness and medical treatment were significantly higher among women and older individuals. ConclusionsA large majority of the adult Portuguese population are likely to reach blood pressure levels defined as hypertension in adulthood. Significant differences in hypertension prevalence were found according to gender, age and socioeconomic status, which highlights the importance of population strategies in public health policies.

Sociodemographic disparities in hypertension prevalence: Results from the first Portuguese National Health Examination Survey

Cardiovascular disease is an important cause of death and disability worldwide, and hypertension is responsible for at least 45% of all deaths due to heart disease and 51% of deaths due to stroke. This study aimed to estimate and describe the distribution of prevalence, awareness, treatment and control of hypertension in the Portuguese population in 2015. A national survey using a representative sample of 4911 individuals residing in Portugal and aged between 25 and 74 years was implemented. Trained nurses performed a health interview and a physical examination, including blood pressure measurement (right arm, three measurements at 1-min intervals). The prevalence of hypertension was stratified by gender, age group, marital status, education, occupation and type of residential area. Associations between hypertension prevalence and sociodemographic factors were assessed using bivariate and multivariate Poisson regression. The overall hypertension prevalence was 36.0%. The highest rates were observed in males (39.6%), in individuals aged between 65 and 74 years (71.3%), and in those with low levels of education (62.6%) and with no formal occupation (64.5%). Among hypertensive individuals, 69.8% were aware of their condition and 69.4% were under treatment, of whom 71.3% were controlled. Rates of awareness and medical treatment were significantly higher among women and older individuals. A large majority of the adult Portuguese population are likely to reach blood pressure levels defined as hypertension in adulthood. Significant differences in hypertension prevalence were found according to gender, age and socioeconomic status, which highlights the importance of population strategies in public health policies. As doenças cardiovasculares são uma importante causa de morte e incapacidade, sendo que a hipertensão arterial (HTA) é responsável por, pelo menos, 45% da mortalidade por doença cardíaca e 51% por acidente vascular cerebral. Este estudo pretende estimar e descrever a distribuição da prevalência, awareness , tratamento e controlo da HTA na população portuguesa em 2015. Realizou-se um inquérito nacional com uma amostra representativa de 4911 indivíduos, dos 25 aos 74 anos, residentes em Portugal, e que compreendia a realização de uma entrevista de saúde e exame físico que incluía a medição da pressão arterial (braço direito, três medidas, intervalos de um minuto). A prevalência de HTA foi estratificada por sexo, grupo etário, estado civil, educação, ocupação e nível de urbanização. Estimou-se a associação entre a HTA e os fatores sociodemográficos usando regressão de Poisson bivariada e multivariada. A prevalência de HTA foi de 36,0%, sendo mais elevada em indivíduos do sexo masculino (39,6%), entre os 65 e 74 anos (71,3%), com baixo nível de escolaridade (62,6%) e sem ocupação formal (64,5%). Dos indivíduos hipertensos, 69,8% tinham conhecimento da sua condição de saúde, 69,4% faziam medicação anti hipertensora e, destes, 71,3% estavam controlados. A prevalência do conhecimento e tratamento farmacológico da HTA foi mais elevada em mulheres e indivíduos mais velhos. A maioria da população adulta portuguesa poderá vir a ter HTA ao longo da vida. Foram encontradas diferenças importantes na prevalência de HTA de acordo com o sexo, a idade e o nível socioeconómico, o que enfatiza a importância de estratégias populacionais nas políticas de saúde pública.

Abstract P123: Antihypertensive Medication Use and Hypertension Control Among Hispanic/Latino Adults With Hypertension: Findings From Hispanic Community Health Study/Study of Latinos

Background: Despite disparities in hypertension prevalence, treatment, and control by Hispanic/Latino background, there is limited information on the role of antihypertensive use in hypertension control. This study estimated antihypertensive use and hypertension control and examined the association between antihypertensive use and hypertension control among Latinos with hypertension. Methods: Data from the Hispanic Community Health Study/Study of Latinos, a population-based cohort study, was used to estimate antihypertensive use and hypertension control among Latinos by background, sociodemographic, clinical, and healthcare factors. Hypertension was defined as systolic BP ≥140, diastolic BP ≥90 mm Hg, or self-reported antihypertensive use. Hypertension control was defined as systolic BP&lt;140 and diastolic BP&lt;90 mm Hg. Antihypertensive use was defined as the use of a diuretic, ACE inhibitor, ARB, β-blocker, CCB, or another antihypertensive in the month prior to study examination. Logistic regressions that examine antihypertensive use and hypertension control were multivariate adjusted. Analyses were limited to Latinos with hypertension in 2014-17 (n=5,354). Results: Antihypertensive use was 58.7% overall and was higher among Cubans (67.4%) when compared to individuals of other backgrounds (Mexican 53.4%, Puerto Rican 59.8%, Dominican 56.3%, Central American 52.0%, South American 49.8%, P&lt;0.001). Commonly used antihypertensive classes include ACE inhibitors (28.3%), diuretics (16.7%), β-blockers (18.0%), ARBs (15.7%), and CCBs (13.0%). Use of antihypertensive classes varied by background—e.g., a greater share of Cubans used β-blockers (26.0%) and ARBs (19.2%) and a greater share of Puerto Ricans used CCBs (17.6%). Less than half of Latinos achieved hypertension control (48.6%); with the highest share of control among Mexicans (54.0%; P&lt;0.001). Among Latinos with treated hypertension, 61.5% achieved control. In adjusted analyses, we found that Cubans had higher odds of antihypertensive use compared to Mexicans (OR 1.63 [CI 1.18-2.26], P&lt;0.01). However, Cubans, Dominicans, and Central Americans had reduced odds of control, even after adjusting for antihypertensive use (OR 0.57 [CI 0.43-0.77]; 0.55 [CI 0.39-0.80]; 0.53 [CI 0.39-0.73]; all P&lt;0.01). Antihypertensive use was positively associated with hypertension control in all backgrounds—in stratified analyses, associations were strongest among Central and South Americans and weakest among Puerto Ricans and Dominicans. Multiple antihypertensive use was not associated with control among Latinos with treated hypertension. Conclusions: The use of antihypertensives varies in Latino adults with hypertension and is associated with differences in hypertension control. Efforts to increase use of antihypertensives can reduce disparities in hypertension control in the diverse Latino population in the US.

Abstract P119: Hypertension Trends in Florida Stroke Patients. The Florida Puerto Rico Collaboration to Reduce Stroke Disparities

Aim: To describe hypertension prevalence (HTN) in a race diverse stroke registry and investigate associated presentation in patients admitted for acute ischemic stroke (AIS) and hemorrhagic stroke in Florida hospitals participating in the Florida Collaboration to Reduce Stroke Disparities (CReSD). Background: HTN affects about 30% of U.S. adults and this prevalence doubles among stroke survivors. HTN is a major risk factor for incident stoke and recurrent stroke. Quantifying the prevalence of HTN in stroke survivors is important to guide secondary stroke prevention. Methods: 121,333 stroke cases were analyzed from 69 FL hospitals participating in the AHA Get With the Guidelines-Stroke Program and FL CReSD Stroke Registry. Hypertension was defined as systolic blood pressure &gt;140mmHg. Demographics and CV risk factors were collected at admission. We investigated the differences in HTN prevalence between race groups: white (65%), black (20%) and Hispanic (15%) as well as between age groups: 18-60, 61-80 and &gt;80 years old. Temporal trends of HTN prevalence were also analyzed from 2010 to 2016. Results: In our stroke population, mean age was 70±15 and 60,667 were women (50%). HTN prevalence was 65% (78,553/121,333). Patients with HTN were significantly older (mean age 72±14 vs. 67±16 in non-HTN patients) and presented significantly higher prevalence of other CV risk factors such as diabetes, hyperlipidemia and had more previous stroke/TIAs. Women had greater prevalence of HTN (66% vs. 64% in males) in all age groups. Greater HTN prevalence was in blacks (70%) compared to white (64%) and Hispanics (58%) in all age groups. Interestingly, a significantly higher prevalence of HTN was found in AIS compared to hemorrhagic stroke but a higher SBP was observed in hemorrhagic strokes compared to AIS. Prevalence of HTN decreased of 8% from 2010 to 2016. Largest decline was observed among women (9%) and blacks (13%). Conclusions: In our large Stroke Registry we observed higher prevalence of HTN in women, blacks and AIS. We also observe a decreasing trend over the past 7 years, especially among women and minorities (blacks and Hispanics). These findings provide an opportunity to design and implement interventions to reduce disparities in HTN and improve stroke outcome.

Prevalence of hypertension and its determinants in an urbanized village of East Delhi

Background: Hypertension is the major public health problem both in developing and developed nations. There is disparity in prevalence of hypertension in rural and urban areas. Data is available on the prevalence of hypertension in both urban and rural areas but studies on migratory population are limited. Methods: A community based cross sectional study conducted in urbanized village of east Delhi. WHO STEPS questionnaire was used collect the data. Total of 451 persons were interviewed by stratified random sampling method. Data analysis was done using SPSS version 16. Results: Prevalence of hypertension was 16.4%, high age group, high income, body mass index more than 23 and duration of stay in urban area were significantly associated with prevalence of hypertension. Conclusions: Older age group, higher BMI and longer duration of stay in urban area have significant associations with the higher prevalence of hypertension.

Racial and Ethnic Subgroup Disparities in Hypertension Prevalence, New York City Health and Nutrition Examination Survey, 2013-2014.

IntroductionRacial/ethnic minority adults have higher rates of hypertension than non-Hispanic white adults. We examined the prevalence of hypertension among Hispanic and Asian subgroups in New York City.MethodsData from the 2013–2014 New York City Health and Nutrition Examination Survey were used to assess hypertension prevalence among adults (aged ≥20) in New York City (n = 1,476). Hypertension was measured (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or self-reported hypertension and use of blood pressure medication). Participants self-reported race/ethnicity and country of origin. Multivariable logistic regression models assessed differences in prevalence by race/ethnicity and sociodemographic and health-related characteristics.ResultsOverall hypertension prevalence among adults in New York City was 33.9% (43.5% for non-Hispanic blacks, 38.0% for Asians, 33.0% for Hispanics, and 27.5% for non-Hispanic whites). Among Hispanic adults, prevalence was 39.4% for Dominican, 34.2% for Puerto Rican, and 27.5% for Central/South American adults. Among Asian adults, prevalence was 43.0% for South Asian and 39.9% for East/Southeast Asian adults. Adjusting for age, sex, education, and body mass index, 2 major racial/ethnic minority groups had higher odds of hypertension than non-Hispanic whites: non-Hispanic black (AOR [adjusted odds ratio], 2.6; 95% confidence interval [CI], 1.7–3.9) and Asian (AOR, 2.0; 95% CI, 1.2–3.4) adults. Two subgroups had greater odds of hypertension than the non-Hispanic white group: East/Southeast Asian adults (AOR, 2.8; 95% CI, 1.6–4.9) and Dominican adults (AOR, 1.9; 95% CI, 1.1–3.5).ConclusionRacial/ethnic minority subgroups vary in hypertension prevalence, suggesting the need for targeted interventions.