scholarly journals Racial and Ethnic Differences in Antihypertensive Medication Use and Blood Pressure Control Among US Adults With Hypertension

Author(s):  
Anna Gu ◽  
Yu Yue ◽  
Raj P. Desai ◽  
Edgar Argulian
2015 ◽  
Vol 29 (1) ◽  
pp. 104-113 ◽  
Author(s):  
Giselle Sarganas ◽  
Hildtraud Knopf ◽  
Daniel Grams ◽  
Hannelore K. Neuhauser

Author(s):  
Yuan Lu ◽  
Yuntian Liu ◽  
Lovedeep Singh Dhingra ◽  
Daisy Massey ◽  
César Caraballo ◽  
...  

Poor hypertension awareness and underuse of guideline-recommended medications are critical factors contributing to poor hypertension control. Using data from 8095 hypertensive people aged ≥18 years from the National Health and Nutrition Examination Survey (2011–2018), we examined recent trends in racial and ethnic differences in awareness and antihypertensive medication use, and their association with racial and ethnic differences in hypertension control. Between 2011 and 2018, age-adjusted hypertension awareness declined for Black, Hispanic, and White individuals, but the 3 outcomes increased or did not change for Asian individuals. Compared with White individuals, Black individuals had a similar awareness (odds ratio, 1.20 [0.96–1.45]) and overall treatment rates (1.04 [0.84–1.25]), and received more intensive antihypertensive medication if treated (1.41 [1.27–1.56]), but had a lower control rate (0.72 [0.61–0.83]). Asian and Hispanic individuals had significantly lower awareness rates (0.69 [0.52–0.85] and 0.74 [0.59–0.89]), overall treatment rates (0.72 [0.57–0.88] and 0.69 [0.55–0.82]), received less intensive medication if treated (0.60 [0.50–0.72] and 0.86 [0.75–0.96]), and had lower control rates (0.66 [0.54–0.79] and 0.69 [0.57–0.81]). The racial and ethnic differences in awareness, treatment, and control persisted over the study period and were consistent across age, sex, and income strata. Lower awareness and treatment were significantly associated with lower control in Asian and Hispanic individuals ( P <0.01 for all) but not in Black individuals. These findings highlight the need for interventions to improve awareness and treatment among Asian and Hispanic individuals, and more investigation into the downstream factors that may contribute to the poor hypertension control among Black individuals.


Author(s):  
Kendra D Sims ◽  
Ellen Smit ◽  
George David Batty ◽  
Perry W Hystad ◽  
Michelle C Odden

Abstract Background Associations between multiple forms of discrimination and blood pressure control in older populations remain unestablished. Methods Participants were 14582 non-institutionalized individuals (59% women) in the Health and Retirement Study aged at least 51 years (76% Non-Hispanic White, 15% Non-Hispanic Black, 9% Hispanic/Latino). Primary exposures included the mean frequency of discrimination in everyday life, intersectional discrimination (defined as marginalization ascribed to more than one reason), and the sum of discrimination over the lifespan. We assessed whether discrimination was associated with change in measured hypertension status (N=14582) and concurrent medication use among reported hypertensives (N=9086) over four years (2008-2014). Results There was no association between the frequency of everyday discrimination and change in measured hypertension. Lifetime discrimination was associated with higher odds of hypertension four years later among men (OR: 1.21, 95% CI: 1.08, 1.36) but not women (OR: 0.98, 95% CI: 0.86, 1.13). Only among men, everyday discrimination due at least two reasons was associated with a 1.44 (95% CI: 1.03, 2.01)-fold odds of hypertension than reporting no everyday discrimination; reporting intersectional discrimination was not associated with developing hypertension among women (OR: 0.91, 95% CI: 0.70, 1.20). All three discriminatory measures were inversely related to time-averaged antihypertensive medication use, without apparent gender differences (e.g., OR for everyday discrimination-antihypertensive use associations: 0.85, 95% CI: 0.77, 0.94)). Conclusions Gender differences in marginalization may more acutely elevate hypertensive risk among older men than similarly aged women. Experiences of discrimination appear to decrease the likelihood of antihypertensive medication use among older adults overall.


2020 ◽  
Vol 22 (8) ◽  
pp. 1406-1414
Author(s):  
Michael E. Ernst ◽  
Enayet K. Chowdhury ◽  
Mark R. Nelson ◽  
Christopher M. Reid ◽  
Karen L. Margolis ◽  
...  

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