Burden of high blood pressure across sociodemographic factors in the United States: A population-based analysis using NHANES (1999-2012)

Background: High blood pressure (HBP) is a major risk factor for cardiovascular diseases (CVD). A growing body of research has identified disparities in HBP across sociodemographic groups (gender, race/ethnicity, marital status, education, poverty).

Methods: National population-based surveys provide estimates of the prevalence of health conditions and help identify subgroups for tailored interventions and potential policy changes. The prevalence and risk factors of HBP among adults(≥20) are investigated with the National Health and Nutrition Examination Survey (NHANES) (1999-2012;n=36,623). A multivariable logistic regression model for having HBP is used to calculate adjusted-odds-ratios (AOR) and 95% confidence intervals (95%CI) for various sociodemographic characteristics by taking into account for complex sampling design. 

Results:HBP prevalence increased from 7.7% in 1999 to 9.3% in 2012. HBP prevalence was higher among males (65.6% vs. 54.6% females), non-Hispanic-Blacks (66.6% vs. 61.3% Whites), widowed/divorced/separated (71.4% vs. 45.8% never-married), people with high school/less (65.3% vs. 54.1% college), and below national poverty level (60.8% vs. 55% above). Majority of people with diabetes (85.2%) and cholesterol (67.2%) also had HBP. In the adjusted model, significant differences in gender (male vs. female [AOR=1.95]:95%CI:1.80-2.12), race/ethnicity (non-Hispanic-Blacks vs. Whites [1.40];1.26-1.54), education (high school/less vs. college [1.40]:1.25-1.56) were found. People with diabetes ([1.72];1.49-1.98) and cholesterol ([1.28];1.20-1.37) also had higher risk for having HBP. 

Conclusions:Our results show that HBP disparities exist among different sociodemographic groups in the US population. Focusing on these groups with the highest prevalence of HBP may provide a base for tailoring future HBP prevention programs that may lead to lowering CVD risk factors.