Racial/ethnic differences in hypertension prevalence, treatment, and control for outpatients in northern California
Beinan Zhao1, Powell O Jose1, Jia Pu1
1Palo Alto Medical Foundation Research Institute, Palo Alto, California, USA;
Insights
Hypertension (HTN) prevalence varies significantly across racial and ethnic groups, with Filipinos and non-Hispanic Blacks (NHBs) facing higher risks and challenges in blood pressure control.
Area of Science:
- Cardiovascular epidemiology
- Public health research
- Health disparities
Background:
- Hypertension (HTN) is a critical cardiovascular disease risk factor.
- Prevalence, treatment, and control of HTN in minority groups like Asian Americans and Hispanics are understudied.
- Existing research often aggregates diverse Asian American subgroups, masking specific health needs.
Purpose of the Study:
- To investigate the prevalence, treatment, and control of hypertension (HTN) across various Asian American subgroups, non-Hispanic Blacks (NHBs), and non-Hispanic Whites (NHWs).
- To identify specific racial and ethnic disparities in HTN management.
- To inform targeted public health interventions for high-risk populations.
Main Methods:
- Analysis of a three-year cross-sectional dataset (2010-2012) from a large ambulatory care setting in Northern California.
- Inclusion of diverse subgroups: Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, Mexicans, NHBs, and NHWs.
- Definition of HTN based on blood pressure measurements, physician diagnosis, or antihypertensive medication use.
Main Results:
- Age-adjusted HTN prevalence varied widely, from 30.0% in Chinese women to 59.9% in Filipino men.
- Filipinos and NHBs exhibited significantly higher odds of having HTN compared to non-Hispanic Whites (NHWs).
- While Asian Americans and NHBs were more likely to receive HTN treatment, blood pressure control was poorer in Filipino women and NHB men compared to NHW counterparts.
Conclusions:
- Significant racial/ethnic variations in HTN prevalence, treatment, and control exist within the study population.
- Filipino and NHB men and women are at elevated risk for hypertension.
- These high-risk groups may encounter greater challenges in achieving adequate blood pressure control, highlighting a critical area for intervention.
Background:
Hypertension (HTN) is a known major cardiovascular disease risk factor, but prevalence, treatment, and control of HTN among rapidly growing minority groups such as Asian Americans and Hispanics are unknown largely due to either underrepresentation in epidemiologic studies or aggregation of Asian American subgroups.
Methods:
A three-year cross-section (2010-2012) of patients from a large ambulatory care setting in northern California was examined in the following subgroups: Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, Mexicans, non-Hispanic Blacks (NHBs), and non-Hispanic Whites (NHWs). We defined HTN as two separate nonemergent office visit blood pressure measurements ≥140/90 mm Hg, physician diagnosis of HTN, or use of antihypertensive medications.
Results:
A total of 208,985 patients were included in the study. Age-adjusted HTN prevalence ranged from 30.0% in Chinese women to 59.9% in Filipino men. Most minority subgroups had lower or similar odds of having HTN compared with NHWs, except for Filipinos and NHBs whose odds were significantly higher after adjusting for patient demographic and clinical characteristics. Asian Americans and NHBs were more likely to be treated for HTN compared with NHWs. Achievement of blood pressure control was lower among Filipino women (odds ratio = 0.82, 99% confidence interval 0.70-0.96) and NHB men (odds ratio = 0.73, 99% confidence interval 0.58-0.91), compared with NHW women and men.
Conclusions:
Substantial racial/ethnic variation in HTN prevalence, treatment, and control was found in our study population. Filipino and NHB women and men are at especially high risk for HTN and may have more difficulty in achieving adequate blood pressure control.
