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APHA Scientific Session and Event Listing

Recorded presentation

Alisa S. Kamigaki, MPH, David J. Reynen, MPH, MPPA, Nan Pheatt, MPH, MT(ASCP), and Lily A. Chaput, MD, MPH. California Heart Disease and Stroke Prevention Program, California Department of Health Services, 1616 Capitol Avenue, Suite 74.317, MS 7212, P.O. Box 997413, Sacramento, CA 95899-7413, (916) 552-9933, AKamigak@dhs.ca.gov

Background: High blood pressure (HBP) increases the risks of heart disease and stroke, the first and third leading causes of death in California and the United States, as well as congestive heart failure, kidney disease, and blindness. Blood-pressure lowering medications (BPLM) are recommended for people with Stage I hypertension or above (³140/90 mmHg). This study describes the prevalence of HBP, the proportion of those with HBP who take BPLM, and factors associated with the use of BPLM, among adults who responded to the 2003 California Health Interview Survey (CHIS).

Method: A total of 42,044 adults responded to CHIS. First, respondents were classified as those who reported having been told by a physician that they had HBP. Age-adjusted prevalence estimates were calculated overall, by gender, and race/ethnicity. Among participants with HBP, the proportion of those using BPLM was determined, by gender and race/ethnicity. Logistic regression was used to describe factors associated with the use of BPLM.

Results: The overall age-adjusted prevalence estimate for HBP is 24.5% (95%CI=24.0%-25.0%). While no difference is observed by gender overall (male: 24.8%, 95%CI=24.0%-25.6%; female: 24.2%, 95%CI=23.5%-24.8%), HBP prevalence is highest for African Americans (35.0%, 95%CI=32.8%-37.1%), with African American females having the highest rate (35.2%, 95%CI=32.78%-37.6%). The lowest prevalence estimate is for whites (23.1%, 95%CI=22.5%-23.7%). Among those with HBP, overall, 49.4% (95%CI=48.1%-50.7%) report using BPLM, with males and females reporting similar use (male: 49.9%, 95%CI=47.9%-52.0%; female: 48.7%, 95%CI=46.9%-50.4%). African Americans report the highest use (56.6%, 95%CI=52.7%-60.5%), and those of “other” race/ethnicity report the lowest use (44.4%, 95%CI=37.8%-50.9%). Finally, the following factors are associated with the use of BPLM among those with HBP, while controlling for age: having seen a physician during the past year (OR=5.23, 95%CI=3.95-6.92); reporting diabetes (OR=2.47, 95%CI=1.92-3.18); having health insurance (OR=2.05, 95%CI=1.63-2.60); being African American (OR=1.71, 95%CI=1.32-2.22); reporting fair/poor health status (OR=1.46, 95%CI=1.23-1.73); reporting heart disease (OR=1.40, 95%CI=1.13-1.75); being a non-smoker (OR=1.38, 95%CI=1.13-1.68); being native-born (OR=1.27, 95%CI=1.05-1.53); and having had some post-secondary education (OR=1.21, 95%CI=1.06-1.38). Gender and alcohol use are not associated with the use of BPLM.

Conclusions: Among people with HBP, undergoing routine medical visits is the strongest predictor of being on BPLM. People with diabetes or a prior history of heart disease are also more likely to be on BPLM, but smokers are not as likely to be treated. Understanding these factors may allow for the development of focused public health strategies to increase BPLM use among people with HBP.

Learning Objectives: