Black/white differences in hypertension in the elderly: an epidemiologic analysis in central North Carolina

Hypertension in blacks, compared with whites, occurs at higher prevalence rates, is more severe, and carries a worse prognosis for cardiovascular morbidity and mortality. The authors examined the degree to which black/white differences in hypertension in the elderly are explained by demographic variables, income, health behavior (smoking, obesity), health service use, and comorbid diabetes. The study population consisted of subjects participating in the Duke site of the Established Populations for Epidemiologic Studies of the Elderly, initiated in 1984. Cross-sectional data reported here were collected between January 1986 and July 1987. Subjects were aged 65 years or older and were not institutionalized. Blacks were oversampled. Of 5,223 eligible persons, 4,163 (80%) agreed to be interviewed; 16% of the study subjects were white men, 30% white women, 19% black men, and 35% black women. The mean age for all groups was approximately 73 years. Forty-four percent of white men, 52% of white women, 50% of black men, and 66% of black women had hypertension. Eighty percent of hypertensives were receiving pharmacologic therapy. Older age, female sex, lower socioeconomic status, obesity, and diabetes mellitus were associated with hypertension. After adjusting for covariables, black race/ethnicity remained an independent risk factor for high blood pressure in the elderly, with an adjusted odds ratio of 1.30.