Factors Associated With the Prevalence of Hypertension in the Southeastern United States

Author:

Sampson Uchechukwu K.A.1,Edwards Todd L.1,Jahangir Eiman1,Munro Heather1,Wariboko Minaba1,Wassef Mariam G.1,Fazio Sergio1,Mensah George A.1,Kabagambe Edmond K.1,Blot William J.1,Lipworth Loren1

Affiliation:

1. From the Department of Medicine (U.K.A.S., T.L.E., E.J., M.W., S.F., E.K.K., W.J.B., L.L.), Department of Pathology, Microbiology, and Immunology (U.K.A.S., S.F.), and Department of Radiology and Radiological Sciences (U.K.A.S.), Vanderbilt University Medical Center, Nashville, TN; International Epidemiology Institute, Rockville, MD (H.M., W.J.B.); School of Osteopathic Medicine, University of Medicine and Dentistry, Newark, NJ (M.G.W.); and Department of Medicine, University of Cape Town, Cape Town...

Abstract

Background— Lifestyle and socioeconomic status have been implicated in the prevalence of hypertension; thus, we evaluated factors associated with hypertension in a cohort of blacks and whites with similar socioeconomic status characteristics. Methods and Results— We evaluated the prevalence and factors associated with self-reported hypertension (SR-HTN) and ascertained hypertension (A-HTN) among 69 211 participants in the Southern Community Cohort Study. Multivariable logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with hypertension. The prevalence of SR-HTN was 57% overall. Body mass index was associated with SR-HTN in all race-sex groups, with the OR rising to 4.03 (95% CI, 3.74–4.33) for morbidly obese participants (body mass index, >40 kg/m 2 ). Blacks were more likely to have SR-HTN than whites (OR, 1.84; 95% CI, 1.75–1.93), and the association with black race was more pronounced among women (OR, 2.08; 95% CI, 1.95–2.21) than men (OR, 1.47; 95% CI, 1.36–1.60). Similar findings were noted in the analysis of A-HTN. Among those with SR-HTN and A-HTN who reported use of an antihypertensive agent, 94% were on at least one of the major classes of antihypertensive agents, but only 44% were on ≥2 classes and only 29% were on a diuretic. The odds of both uncontrolled hypertension (SR-HTN and A-HTN) and unreported hypertension (no SR-HTN and A-HTN) were twice as high among blacks as whites (OR, 2.13; 95% CI, 1.68–2.69; and OR, 1.99; 95% CI, 1.59–2.48, respectively). Conclusions— Despite socioeconomic status similarities, we observed suboptimal use of antihypertensives in this cohort and racial differences in the prevalence of uncontrolled and unreported hypertension, which merit further investigation.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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