scholarly journals National Trends in Racial and Ethnic Disparities in Antihypertensive Medication Use and Blood Pressure Control Among Adults With Hypertension, 2011–2018

Hypertension ◽  
2021 ◽  
Author(s):  
Yuan Lu ◽  
Yuntian Liu ◽  
Lovedeep Singh Dhingra ◽  
Daisy Massey ◽  
César Caraballo ◽  
...  
Keyword(s):  
Ethnic Differences ◽  
Antihypertensive Medication ◽  
Medication Use ◽  
Ethnic Disparities ◽  
Pressure Control ◽  
Hypertension Control ◽  
Racial And Ethnic Differences ◽  
Hypertension Awareness ◽  
Using Data ◽  
National Trends

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.

scholarly journals Trends in Awareness, Antihypertensive Medication Use and Blood Pressure Control by Race and Ethnicity Among Adults with Hypertension in the United States: A National Health and Nutrition Examination Analysis from 2011 to 2018

2021 ◽  
Author(s):  
Yuan Lu ◽  
Yuntian Liu ◽  
Lovedeep S Dhingra ◽  
Daisy Singh Massey ◽  
Cesar Caraballo ◽  
...  
Keyword(s):  
United States ◽  
Blood Pressure ◽  
Ethnic Differences ◽  
National Health ◽  
Antihypertensive Medication ◽  
Medication Use ◽  
Health And Nutrition ◽  
Hypertension Awareness ◽  
And Control ◽  
Racial Ethnic

Objective: To examine United States (US) trends in racial/ethnic differences in hypertension awareness and antihypertensive medication use, and whether these differences help explain racial/ethnic differences in hypertension control among adults from 2011 to 2018. Design: Population-based study. Setting: National Health and Nutrition Examination Survey (NHANES), 2011-2018. Participants: A nationally representative sample of US adults aged 18 years or older. Main outcome measures: Hypertension awareness was defined as self-reported physician diagnosis of hypertension. Antihypertensive treatment was based on self-reported use of antihypertensive agents. Blood pressure (BP) control was measured systolic BP <140 mmHg and diastolic BP <90 mmHg. Results: This study included 8,095 adults with hypertension from NHANES 2011-2018. During the study period, age-adjusted hypertension awareness declined from 84.0% (95% confidence interval 79.5 to 86.2) to 77.5% (74.0 to 80.5), hypertension treatment declined from 77.3% (73.4 to 81.1) to 71.4% (69.0 to 73.8) and control rates declined from 51.9% (47.1 to 56.7) to 43.1% (39.7 to 46.5). These declines were consistent for Black, Hispanic, and White individuals, but the three outcomes increased or did not change for Asian individuals. Compared with White individuals, Black individuals did not have a significantly different awareness (odds ratio:1.20 [0.96 to 1.45]) and overall treatment rate (1.04 [0.84 to 1.25]), but received more antihypertensive medications if treated (1.41 [1.27 to 1.56]), and had a lower BP control rate (0.72 [0.61 to 0.83]); Asian and Hispanic individuals had significantly lower awareness rates (0.69 [0.52 to 0.85] and 0.74 [0.59 to 0.89], respectively), overall treatment rates (0.72 [0.57 to 0.88] and 0.69 [0.55 to 0.82]), received fewer medications if treated (0.60 [0.50 to 0.72] and 0.86 [0.75 to 0.96]), and had lower BP control rates (0.66 [0.54 to 0.79] and 0.69 [0.57 to 0.81]). The racial/ethnic differences in awareness, treatment, and BP control persisted over the study period and were consistent across age, sex, and income strata. Lower awareness and treatment were associated with lower BP control in Asian and Hispanic individuals, but not in Black individuals. Conclusions: Hypertension awareness, treatment, and control declined from 2011-2018, and this decline was consistent for Black, Hispanic, and White individuals. BP control was worse for Asian, Black, and Hispanic individuals than for White individuals over the entire study period; this was explained partly by differences in awareness and treatment for Asian and Hispanic individuals, but not for Black individuals.

Distrust and Empathy: Explaining the Lack of Support for Capital Punishment Among Minorities

2018 ◽  
Vol 44 (2) ◽  
pp. 204-230 ◽  
Author(s):  
Wanda D. Foglia ◽  
Nadine M. Connell
Keyword(s):  
Ethnic Differences ◽  
Capital Punishment ◽  
Justice System ◽  
The United States ◽  
White Americans ◽  
Racial And Ethnic Differences ◽  
Capital Jury ◽  
Using Data ◽  
Public Opinion Polls ◽  
Opinion Polls

Public opinion polls show that the majority of people in the United States support capital punishment but that is because the majority of White Americans support it. Research on the opinions of non-Whites consistently finds less support. We examine racial and ethnic differences among people who actually had to decide whether to impose the death penalty, former capital jurors, and hypothesize that lower support among non-Whites can be explained by the fact that non-Whites are more likely to distrust the criminal justice system and more likely to show empathy for the defendant in a capital case, net of defendant and victim race. Using data from the Capital Jury Project, we find support for this hypothesis in a mediating relationship between race and sentencing vote. Black and Hispanic jurors are more likely to report distrust of the capital process and higher levels of empathy for the defendant, both of which lower the probability of a death vote during the sentencing phase of the trial. We discuss the implications for research, trial strategy, and the future of capital punishment in light of these findings.

scholarly journals Recent Trends and Characteristics Associated with Influenza Vaccination Disparities among Texas Children

2016 ◽  
Author(s):  
Lloyd B Potter ◽  
Corey Sparks ◽  
Bradley Pollock
Keyword(s):  
Health Care ◽  
Ethnic Differences ◽  
Access To Health Care ◽  
Seasonal Influenza ◽  
Immunization Coverage ◽  
White Children ◽  
Racial And Ethnic Differences ◽  
Influenza Immunization ◽  
Access To Health ◽  
Using Data

Adequate immunization of children protects them common infections and may serve as an indicator of access to health care. Racial and ethnic differentials in immunization of children may suggest differentials in access to health care. This research describes racial and ethnic differences in childhood influenza immunization coverage and identifies social and economic characteristics associated with these immunization differentials in Texas.Methods: Using data from the National Immunization Survey racial and ethnic differences in seasonal influenza immunization among children is examined as related to social and economic characteristics of children in Texas over the period of 2004 to 2013.Results: Findings suggest the presence of expected differences in childhood seasonal influenza immunization for Hispanic and non-Hispanic black children compared to non- Hispanic white children. Education and marital status of the mother are predictors of influenza immunization as is participation in WIC.Conclusions: Implications of findings suggest the need for qualitative research to better understand barriers to immunization that differentially affect minority children in Texas. Addressing racial and ethnic immunization differentials among children may potentially result in reductions in other racial and ethnic health disparities as they age.

scholarly journals Hypertension Awareness, Treatment, and Control in US Adults: Trends in the Hypertension Control Cascade by Population Subgroup (National Health and Nutrition Examination Survey, 1999–2016)

2019 ◽  
Vol 188 (12) ◽  
pp. 2165-2174 ◽  
Author(s):  
Kathryn Foti ◽  
Dan Wang ◽  
Lawrence J Appel ◽  
Elizabeth Selvin
Keyword(s):  
Older Women ◽  
National Health ◽  
Ethnic Disparities ◽  
Nutrition Examination Survey ◽  
Hypertension Control ◽  
Health And Nutrition ◽  
Population Subgroup ◽  
Younger Men ◽  
Hypertension Awareness ◽  
And Control

Abstract Examination of changes in hypertension awareness, treatment, and control (i.e., the hypertension control cascade) by population subgroup can inform targeted efforts to improve hypertension control and reduce disparities. We analyzed 1999–2016 data from the National Health and Nutrition Examination Survey and examined trends across 6-year periods in hypertension awareness, treatment, and control by age, sex, and race/ethnicity. We included 39,589 participants (16,141 with hypertension). Hypertension awareness, treatment, and control increased from 1999 to 2016 among all age groups. However, there were few changes after 2010. Across all time periods, awareness, treatment, and control were higher among younger women (ages 25–44 years) than among younger men, while control was higher among older men (ages ≥65 years) than among older women. Hypertension control was persistently lower for blacks than for whites of all ages, and awareness, treatment, and control were lower among younger Hispanics. There have been few changes in hypertension awareness, treatment, and control since 2010. Disparities in hypertension control by sex highlight the need for effective interventions among younger men and older women. Concerted efforts are also needed to reduce persistent racial/ethnic disparities, particularly to improve treatment control among blacks and to further address gaps at all stages among younger Hispanics.

scholarly journals Trends in Antihypertensive Medication Use and Blood Pressure Control Among Adults With Hypertension in Germany

2015 ◽  
Vol 29 (1) ◽  
pp. 104-113 ◽  
Author(s):  
Giselle Sarganas ◽  
Hildtraud Knopf ◽  
Daniel Grams ◽  
Hannelore K. Neuhauser
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Antihypertensive Medication ◽  
Medication Use ◽  
Pressure Control

Abstract P258: Antihypertensive Medication Nonadherence Among Hispanic Adults by Healthcare Access and Acculturation Characteristics - Estilos Survey, 2015

Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Carma Ayala ◽  
Xin (Cindy) Tong ◽  
Carol Ochoa ◽  
Carla Mercado ◽  
Jing Fang
Keyword(s):  
Medication Adherence ◽  
Antihypertensive Medication ◽  
Healthcare Access ◽  
Age Groups ◽  
Medication Use ◽  
Pressure Control ◽  
Care Physician ◽  
Hispanic Adults ◽  
The Usa ◽  
Public Health Practitioners

Medication adherence for hypertensive adults (HTNs) is an important factor in achieving and maintaining blood pressure control, as it has been associated with better health outcomes and lower costs of medical care. We assessed the differences in the prevalence of self-reported antihypertensive medication use and adherence among Hispanic HTNs by selected characteristics. Methods: ESTILOS is an online panel for health survey data of Hispanic adults in the USA. In 2015, 1,000 adults completed the survey with a response rate of 29%. The resulting data were weighted using 8 factors: gender, age, household income, household size, education, census region, country of origin, and acculturation (based on years living in the USA, language spoken at home, cultural self-identification, and use of Spanish language). The differences among characteristics for prevalence ± standard error of medication use and adherence were compared by using χ 2 statistics. Results: The prevalence of hypertension was 27.5±2.7%. The prevalence of antihypertensive medication use in HTNs was 67.9±4.6%) overall and was higher among those ≥55 years of age (95.2±2.1%; P =<0.0001), retirees (92.3±4.0%; P =0.0002), who had healthcare coverage (72.5±4.8%; P =0.02) and had a primary care physician (PCP) (71.9±4.9%; P =0.03), did not have any reported cost barriers to seeing their PCP within past 12 months (71.9±5.3%; P =0.001), and took 3-4 lifestyle actions (79.7±5.4%; P =0.015) than <3 lifestyle actions). Among HTNs taking antihypertensives, 24.0±7.0% reported missing or skipping medication doses. HTNs aged <55 years or who could not see a PCP within the past year due to cost barriers, were more likely to miss or skip doses of antihypertensive medication (<55=54.1±13.4%) vs >55=11.5±5.3%; P =0.03 and could not see PCP=45.2±12.1% vs 12.0±5.2%; 0.01, respectively). Conclusion: Poor antihypertensive medication adherence among Hispanics with hypertension was associated with younger age groups and those who reported barriers to engaging with a PCP. Public health practitioners and clinicians can utilize this information to support their programs and can tailor strategies for improved outcomes.

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