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Adverse social determinants of health elevate uncontrolled hypertension risk: a cardio-oncology prospective cohort

Priyanshu Nain1,2, Nickolas Stabellini2,3,4, Omar M Makram1,2

  • 1Department of Medicine, Division of Cardiology, and Vascular Biology Center, Medical College of Georgia at Augusta University, Augusta, GA, USA.

JNCI Cancer Spectrum
|August 8, 2024
PubMed

Insights

High social determinants of health (SDOH) scores increase the risk of uncontrolled hypertension (HTN) in cancer patients. Addressing SDOH factors is crucial for managing HTN in this population.

Area of Science:

  • Cardio-oncology
  • Public Health
  • Hypertension Management

Background:

  • The influence of social determinants of health (SDOH) on hypertension (HTN) control in cancer patients remains largely unexamined.
  • Hypertension is a common comorbidity and a significant concern in cancer care.

Purpose of the Study:

  • To investigate the association between SDOH and the control of hypertension in cancer patients.
  • To test the hypothesis that higher SDOH scores are linked to poorer HTN control.

Main Methods:

  • Prospective study involving 318 cancer patients with hypertension.
  • Utilized the Protocol for Responding to & Assessing Patients' Assets, Risks & Experiences questionnaire for SDOH assessment.
  • Defined uncontrolled HTN using integrated home and clinic blood pressure readings (≥140/90 mm Hg).
  • Employed Cox regression analysis to determine the impact of SDOH on HTN control, adjusting for covariates.

Main Results:

  • Prevalent adverse SDOH included stress, educational insecurity, and social isolation.
  • High SDOH scores were associated with a 77% increased risk of uncontrolled hypertension (aHR=1.77, P=.018).
  • Urban residents with high SDOH faced an even greater risk of uncontrolled HTN.

Conclusions:

  • Elevated SDOH scores significantly correlate with uncontrolled hypertension in cancer patients.
  • Identifying and addressing SDOH is essential for improving HTN management in cardio-oncology settings.
  • Interventions targeting SDOH may be vital for optimizing cardiovascular health in cancer survivors.

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