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Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
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Geospatial Patterning of Hypertension and High Cholesterol Prevalence in Inland Southern California: An Ecological

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Cardiovascular disease risk factors like hypertension and high cholesterol are spatially clustered in California's Inland Empire. Neighborhood factors such as obesity, income, and healthcare access are linked to these health disparities.

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Area of Science:

  • Public Health Surveillance
  • Geospatial Analysis
  • Cardiovascular Disease Epidemiology

Background:

  • California's Inland Empire (IE) is a Health Professional Shortage Area (HPSA) with significant cardiovascular disease (CVD) burdens.
  • Limited regional health surveillance necessitates spatial analysis of CVD risk factors.

Purpose of the Study:

  • To assess spatial clustering of hypertension and high cholesterol in the IE.
  • To examine associations between these conditions and neighborhood-level characteristics using spatial models.

Main Methods:

  • Cross-sectional ecological study utilizing 2025 CDC PLACES data and 2019-2023 ACS data for 132 ZCTAs in Riverside and San Bernardino counties.
  • Spatial econometric workflow including Moran's I for clustering and Spatial Error Models (SEM) for adjusted analyses.
  • Variance inflation factors (VIF) and diagnostic ordinary least squares (OLS) regression were employed.

Main Results:

  • Significant geospatial clustering was observed for both hypertension (I = 0.293, p < 0.001) and high cholesterol (I = 0.162, p = 0.002).
  • SEM-adjusted models revealed associations between hypertension/high cholesterol and obesity (positive), recent checkups (positive), and median income (negative).
  • Mean modeled prevalence was 34.3% for hypertension and 36.5% for high cholesterol across ZCTAs.

Conclusions:

  • Hypertension and high cholesterol prevalence in the IE exhibit spatial clustering and ZCTA-level variation.
  • Neighborhood factors including obesity, income, and healthcare engagement are associated with cardiovascular risk.
  • Findings support spatial surveillance for informing public health strategies in underserved regions.