Changes in Rates of Uncontrolled Hypertension Among Federally Qualified Health Center Patients, 2019 to 2022:...

Area of Science:

• Public Health
• Cardiovascular Health
• Health Disparities

Background:

• COVID-19 pandemic disrupted US primary care and chronic disease management.
• Hypertension control may have been impacted differently across populations, especially those with limited healthcare access.
• Federally Qualified Health Centers (FQHCs) serve vulnerable populations, making them key sites for studying pandemic impacts.

Purpose of the Study:

• To examine state-level trends in uncontrolled hypertension among FQHC patients during and after the COVID-19 pandemic.
• To identify patterns in hypertension control across different racial and ethnic groups.
• To explore the association between hypertension control trajectories and state-level COVID-19 mortality rates.

Main Methods:

• Analysis of 2019-2022 Uniform Data System data for FQHC patients.
• Application of group-based trajectory modeling to identify state-level patterns.
• Examination of associations between trajectory groups and state COVID-19 mortality rates.

Main Results:

• Four distinct trajectory groups for uncontrolled hypertension were identified across all races.
• The least favorable trajectory group (consistently high rates) included 5 states for the general population.
• Among non-Hispanic Black patients, 24 states were in the least favorable trajectory group, indicating significant racial disparities.

Conclusions:

• Hypertension control generally rebounded to pre-pandemic levels by 2022, but significant geographic and racial disparities remain.
• Patients in states with the least favorable hypertension control trends require targeted management strategies.
• Sustaining chronic disease care during public health crises and addressing structural factors are crucial for improving health outcomes.