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Who Are the Undiagnosed? Disparities in Hypertension Diagnoses in Vulnerable Populations

Margaret Meador1, Joy H Lewis, R Curtis Bay

  • 1National Association of Community Health Centers, Bethesda, Maryland (Mss Meador and Jackson); Department of Public Health, School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa (Dr Lewis); Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa (Dr Bay); and Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Wall).

Family & Community Health
|November 26, 2019
PubMed

Insights

This study identified potential disparities in hypertension diagnosis among undiagnosed patients. Older, Black, uninsured, and obese individuals were more likely to be diagnosed with hypertension, suggesting possible biases in care.

Area of Science:

  • Clinical Medicine
  • Public Health
  • Health Equity

Background:

  • Hypertension remains a significant public health concern, often diagnosed late.
  • Previous research developed "hiding in plain sight" (HIPS) criteria to identify patients with undiagnosed hypertension.
  • Understanding diagnostic disparities is crucial for equitable healthcare delivery.

Purpose of the Study:

  • To investigate potential demographic disparities in hypertension diagnosis among patients identified by HIPS criteria.
  • To examine patient characteristics associated with hypertension diagnosis after HIPS identification.
  • To explore nonclinical factors influencing hypertension diagnosis.

Main Methods:

  • Retrospective analysis of electronic health record demographic data.
  • Inclusion of patients identified by HIPS criteria across three Missouri health centers.
  • Comparison of demographic and clinical characteristics between diagnosed and undiagnosed subgroups.

Main Results:

  • Patients diagnosed with hypertension post-HIPS identification were more frequently older, Black/African American, uninsured, and had obesity.
  • Younger, white, healthy weight females were less likely to receive a hypertension diagnosis.
  • Significant demographic differences were observed in hypertension diagnosis rates.

Conclusions:

  • Hypertension diagnosis may be influenced by demographic factors and potential biases.
  • Further investigation into nonclinical factors is warranted to address diagnostic inequities.
  • Ensuring equitable hypertension diagnosis requires addressing systemic biases in healthcare.

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