Hypertension and the mortality crossover among non-Hispanic Blacks and Whites aged 80 years and older in the U.S

After age 85, blacks had lower mortality rates than whites. The causes remain unexplained. It has been hypothesized that blood pressure may be better controlled in older Black adults compared to their White counterparts. This study hypothesized that exposures to uncontrolled hypertension were not greater in non-Hispanic Black (NHB) than in non-Hispanic White (NHW) at ages 80 and older in a population-based national survey.

Data on demographics, self-reported diagnoses and risk factors of NHB and NHW aged 80 years and older were examined in the National Health and Nutrition Examination Survey (NHANES), cycles 2007 - 2008 through 2017- March 2020. Statistical analysis was done taking complex survey design and analysis weights into account.

Prevalence of a history of doctor-diagnosed hypertension was 76 % in NHB versus 65 % in NHW. Among those with history of hypertension, 90.65 % of NHW and 91.19 % of NHB reported taking blood pressure (BP) medication (p = 0.9). In NHW mean (95 % confidence interval) systolic BP was 138.4 (135.4-141.4) and in NHB 146.5 (140.8-152.3).

Compared to NHW, NHB were more likely to have less than high school education, live in poverty, and be unmarried. Similar to younger ages, at 80 years and older, NHB had greater hypertension prevalence, similar level of treatment of diagnosed high BP, and higher systolic BP compared to NHW. Further studies are needed in samples with larger numbers of NHB aged 85 and older.