Factors associated with the prevalence of hypertension in the southeastern united states insights from 69 211 blacks and whites in the southern community cohort study

Uchechukwu K.A. Sampson, Todd L. Edwards, Eiman Jahangir, Heather Munro, Minaba Wariboko, Mariam G. Wassef, Sergio Fazio, George A. Mensah, Edmond K. Kabagambe, William J. Blot, Loren Lipworth

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    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 SRHTN 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/m2). 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.

    Original languageEnglish (US)
    Pages (from-to)33-54
    Number of pages22
    JournalCirculation: Cardiovascular Quality and Outcomes
    Volume7
    Issue number1
    DOIs
    StatePublished - Jan 2014

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    Keywords

    • African Continental Ancestry Group
    • European Continental Ancestry Group
    • Hypertension
    • Prevalence

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

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