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

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.

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“…For example, the rates of elevated blood pressure identified in this study corroborate with studies of black individuals (primarily African Americans) within in the US; however, refugees are a unique group and comparison should be taken with caution. [23,24,25] Research available for comparison has identified elevated hypertension risk in samples which combined African refugees (including Congolese) vs. other refugee groups. [8] Hypertension risk has also been found to increase by 6.6-6.8% for each additional year a refugee resides in the US.…”

Behavioural and psychosocial factors associated with 5‐year weight trajectories within the PORTAL Overweight/Obesity Cohort

“…As described in detail elsewhere, the PORTAL cohort includes more than 5 million individuals with overweight and obesity and reflects the underlying regional race, ethnicity, and neighbourhood education and income distributions of the participating health systems. In a previous analysis of this cohort, the prevalence of hypertension was greater for Blacks, American Indians/Alaska Natives, Asians, and Native Hawaiians/Pacific Islanders compared with Whites despite being in the same BMI category and neighbourhood education level . Furthermore, racial/ethnic minorities in this cohort had a higher burden of prediabetes and diabetes at lower BMIs than Whites .…”

Prevalence of modifiable cardiovascular risk factors in Yazd inner-city municipalities

“…[4] The association between cardiovascular disease and their risk factors and socioeconomic factors has been reported in many studies. [12][13][14] A relationship between social determinants and lifestyle behaviors like physical inactivity, tobacco smoking, and dietary habits and cardiovascular disease mortality has been reported [15][16] as well as the relationship between Socio-Economic Status (SES) and Type-2 diabetes mellitus(T2DM), [17] hypercholesterolemia, [18] obesity and high blood pressure [19] has been documented. The historical city of Yazd has a new urban texture along with the old area.…”