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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.

Sampson UK, Edwards TL, Jahangir E, Munro H, Wariboko M, Wassef MG, Fazio S, Mensah GA, Kabagambe EK, Blot WJ, Lipworth L
Circ Cardiovasc Qual Outcomes. 2014 7 (1): 33-54

PMID: 24365671 · PMCID: PMC3962825 · DOI:10.1161/CIRCOUTCOMES.113.000155

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.

MeSH Terms (21)

Adult African Continental Ancestry Group Aged Age Factors Body Mass Index Cohort Studies Continental Population Groups Cross-Sectional Studies European Continental Ancestry Group Female Humans Hypertension Life Style Logistic Models Male Middle Aged Patient Compliance Prevalence Risk Factors Social Class Southeastern United States

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