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Associations of overweight/obesity and socioeconomic status with hypertension prevalence across racial and ethnic groups.

Authors
  • Young, Deborah Rohm1
  • Fischer, Heidi1
  • Arterburn, David2
  • Bessesen, Daniel3
  • Cromwell, Lee4
  • Daley, Matthew F5
  • Desai, Jay6
  • Ferrara, Assiamira7
  • Fitzpatrick, Stephanie L8
  • Horberg, Michael A9
  • Koebnick, Corinna1
  • Nau, Claudia L1
  • Oshiro, Caryn10
  • Waitzfelder, Beth10
  • Yamamoto, Ayae1
  • 1 Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
  • 2 Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
  • 3 Denver Health, Denver, CO, USA.
  • 4 Kaiser Permanente Georgia, Atlanta, GA, USA. , (Georgia)
  • 5 Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA.
  • 6 HealthPartners Institute for Education and Research, Bloomington, MN, USA.
  • 7 Department of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
  • 8 Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA.
  • 9 Mid-Atlantic Permanente Research Institute, Rockville, MD, USA.
  • 10 Center for Health Research, Kaiser Permanente Hawaii, Honolulu, HI, USA.
Type
Published Article
Journal
Journal of Clinical Hypertension
Publisher
Wiley (Blackwell Publishing)
Publication Date
Mar 01, 2018
Volume
20
Issue
3
Pages
532–540
Identifiers
DOI: 10.1111/jch.13217
PMID: 29432662
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Racial/ethnic disparities in the prevalence of diagnosed hypertension are persistent but may be partially explained by racial/ethnic differences in weight category and neighborhood socioeconomic status. The authors compared hypertension prevalence rates among 4 060 585 adults with overweight or obesity across 10 healthcare systems by weight category and neighborhood education level in geographically and racially diverse individuals. Data were obtained from electronic health records. Hypertension was defined as at least two outpatient visits or one inpatient hospitalization with a coded diagnosis. Logistic regression, adjusted for age, sex, and site, with two-way interactions between race/ethnicity and weight category or neighborhood education, was used to examine the association between hypertension and race/ethnicity, with whites as the reference. Results documented that odds ratios for hypertension prevalence were greater for blacks, American Indians/Alaskan Natives, Asians, and Native Hawaiians/other Pacific Islanders compared with whites and lower for Hispanics in similar weight categories and neighborhood education levels. Although two-way interactions were statistically significant, the magnitude of the odds of hypertension compared with whites did not substantially vary across weight or neighborhood education. Hypertension odds were almost double relative to whites for blacks and Native Hawaiians/other Pacific Islanders across most weight categories and all neighborhood education levels. Odds of hypertension were about 50% greater for Asians relative to whites across weight categories. Results suggest that other factors might be associated with racial/ethnic disparities in hypertension. More research is needed to understand the many factors that may contribute to variation in diagnosed hypertension across racial/ethnic groups with overweight or obesity. ©2018 Wiley Periodicals, Inc.

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