264767 Temporal trends in race and sex differences in the age-gradient of hypertension

Sunday, October 28, 2012

Arline T. Geronimus, ScD , Department of Health Behavior and Health Education, School of Public Health, and Population Studies Center, University of Michigan, Ann Arbor, MI
John Bound, PhD , Department of Economics and Population Studies Center, University of Michigan, Ann Arbor, MI
Linnea A. Evans, MPH , Department of Health Behavior and Health Education, School of Public Health, and Population Studies Center, University of Michigan, Ann Arbor, MI
Background: Earlier analyses of NHANES data showed rates of early-onset hypertension increased dramatically over the 1990s, especially among Black women. This study assessed if this steep age-gradient increase in hypertension prevalence was sustained in the most recent cycles of NHANES (2007-2010).

Methods: Using logistic regression, we predicted sex- and age-specific probabilities of being hypertensive for Blacks and Whites, ages 15-65, in NHANES 2007-2010. Age-specific Black-to-White odds ratios were estimated and adjusted for BMI and poverty-income-ratio. Comparisons were made across NHANES-cycles.

Preliminary results: The increased hypertension prevalence among women observed in NHANES 1999-2002 remained in 2007-2010, with Black women exhibiting the highest hypertension prevalence of the race/sex groups studied. White men experienced a slight increase in hypertension prevalence (22% vs. 26% p<.05) that was evident beginning at age 35. Black men, ages 15-34, experienced a small decrease, narrowing the Black-to-White OR for men to insignificance at ages younger than 35. No significant changes between the time periods were observed in the age-gradients for Black or White women, leaving Black women with the steepest age-gradient increase in hypertension. Adjustment for PIR did not affect the magnitude of the disparities; inclusion of BMI attenuated, but did not fully account for black women's increased risk.

Conclusion: Blacks continue to experience higher rates of hypertension and earlier onset. There is a need to investigate social or environmental processes particularly relevant to the production of hypertension in young through middle-aged Black women.

Learning Areas:
Chronic disease management and prevention
Epidemiology
Implementation of health education strategies, interventions and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
Learning Objectives: 1.) Compare the risk of hypertension across black and white men and women of working ages, and how these patterns have persisted over the past decade. 2.) Describe the age-gradient of hypertension prevalence in young through middle-aged adults, and the changes that have occurred for men over the past decade. 3.) Identify the effects of poverty and BMI on racial disparities in hypertension for both men and women. 4.) Discuss the implications of early onset of hypertension, especially for complicating pregnancy in women, resulting in adverse maternal and fetal outcomes.

Keywords: Health Disparities, Women's Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Doctoral Candidate in public health and a Population Studies Trainee at the University of Michigan. I conducted the analyses and participated in the final write-up.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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