Patients who were African-American, Asian, American Indian/Alaska Native, or Native Hawaiian and other Pacific Islanders had an increased risk for hypertension compared with those who were white or Hispanic regardless of weight category, neighborhood status or education level, according to a study published in the Journal of Clinical Hypertension.
“This research shines new light on how pervasive the racial/ethnic disparities are in hypertension, and that the prevalence of hypertension among American Indians, Native Hawaiians and Asians is nearly as high as that of African-Americans,” Deborah Rohm Young, PhD, director of behavioral research in the department of research and evaluation at Kaiser Permanente Southern California in Pasadena, said in a press release. “Results from this study may provide information that could lead to better targeting of interventions to reduce hypertension, not only by race/ethnicity, but possibly by weight category or social economic status.”
Overweight, obese adults
Researchers analyzed data from 4,060,585 patients older than 18 years with obesity or overweight. Patients identified themselves as black or African-American (11.4%), Asian (13.1%), Hispanic (24.8%), Native Hawaiian or other Pacific Islander (1.5%), white (48.6%) or American Indian/Alaska Native (0.6%).
Patients of all races/ethnicities except Asians had a BMI of at least 25 kg/m2, which was confirmed through their electronic health records. Asian patients had a BMI of at least 23 kg/m2. All patients except Asian patients were categorized as overweight if BMI were 25 kg/m2 to 29.9 kg/m2, obese class 1 if BMI were 30 kg/m2 to 34.9 kg/m2, obese class 2 if BMI were 35 kg/m2 to 39.9 kg/m2 and obese class 3 if BMI were greater than 40 kg/m2). Asian patients were categorized as overweight if they were 23 kg/m2 to 27.4 kg/m2, obesity class 1 if they were 27.5 kg/m2 to 32.4 kg/m2, obesity class 2 if they were 32.5 kg/m2 to 37.4 kg/m2 and obesity class 3 if they were greater than 37.5 kg/m2.
Hypertension was defined as one inpatient hospitalization with a coded diagnosis of hypertension or at least two outpatient visits with a diagnosis of hypertension.
Geocoding was performed to estimate neighborhood education.
Hypertension was diagnosed in 36.9% of patients.
Increased risk for hypertension
ORs for the prevalence of hypertension were greater in American Indian/Alaska Native patients (OR = 1.17; 95% CI, 1.13-1.2), black patients (OR = 2.02; 95% CI, 2-2.03), Asian patients (OR = 1.42; 95% CI, 1.41-1.43) and Native Hawaiian or other Pacific Islander patients (OR = 1.85; 95% CI, 1.81-1.9) compared with white patients in similar weight categories and neighborhood education levels. Hispanic patients were less likely to have hypertension (OR = 0.96; 95% CI, 0.95-0.97) compared with white patients.
Across races and ethnicities, the odds for developing hypertension did not substantially vary across neighborhood education and weight, although two-way interactions were statistically significant for both categories (P < .0001).
Compared with white patients, the odds of developing hypertension were doubled for black patients, 20% greater for American Indian/Alaska Native patients and between 36% and 46% greater for Asian patients at all neighborhood education levels.
“Disparities remain across weight class and neighborhood education level, suggesting that other factors might be driving forces of racial/ethnic disparities in hypertension,” Young and colleagues wrote. “More research is needed to understand the many factors that may contribute to the variation in hypertension prevalence across racial/ethnic groups.” – by Darlene Dobkowski
The authors report no relevant financial disclosures.