Social Networks and Support, Gender, and Racial/Ethnic Disparities in Hypertension Among Older Adults

Abstract

Using data from the 2001 NHIS and the -2006 we examine how self-reporting a previous diagnosis of hypertension among adults aged 65? differs by race/ethnicity for men and women; we explore the extent to which disparities are driven by group differences in social risk factors, particularly social support and integration; and last, whether these relationships mimic patterns seen for measured hypertension at interview. Findings indicate that rates of ever-diagnosed hypertension in both samples are highest among black seniors and older women and lowest among Mexican-American men, with the gender gap lowest among whites and substantially higher among blacks and Mexican-Americans. However, replication analyses of NHANES models using measured hypertension, instead of a self-report of having ever been diagnosed with hypertension, suggests that reporting bias and measurement error contribute to observed disparities, as racial/ethnic differences in hypertension rates are smaller when measured hypertension is examined, especially among women. Logistic regression models also show that while adjusting for group differences in measures of support and integration mediates some of the disparity in measured hypertension between Mexican-American and white seniors, adjusting for support and integration amplifies black-white disparities in both ever diagnosed and measured hypertension-driven primarily by adjustment for attendance at religious services, which reduces hypertension risk for all older adults but is more commonly reported among black seniors, especially women.

Evaluation of the Distribution and Factors Affecting Blood Pressure Using Medical Checkup Data in Japan

“…As for age, as individuals grew 10 years older, their average SBP increased as much as 5 mmHg. BP and the risks of hypertension have been studied using a cohort study [12] [24]. A 10-year interval was used to define the age cohorts; however, the results of this study suggest that the 10 year interval might be too large, the distribution within cohorts should not be ignored, and the age cohorts should be revised to get more precise evaluations.…”

“…Joffres et al [22] [23] pointed out that there were large differences between the distributions of SBP among Kenyan nomads and London civil servants, with the levels of the former much lower than the levels of the latter. It has also been suggested that race, genetic and environmental factors, and health administrative and practice patterns are important determinants of BP [4] [10] [24]. Therefore, it is necessary to evaluate the BP data by country.…”

Does High Systolic Blood Pressure Truly Increase Medical Expenditure?—An Empirical Analysis of the New 2017 ACC/AHA Hypertension Guideline

“…Race, genetic and environmental factors, and health administrative activities are important factors for BP [7] [23] [24]. For example, Rose [25] compared the distribution of SBP in Kenyan nomads and London civil servants, and found that the former was much lower than the latter.…”

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“…Moreover, BP levels were strongly affected by various factors such as the age, gender, health conditions, and lifestyles of the individuals. Race, genetic and environmental factors, and health administrative activities are also important factors for BP [17] [18] [19]. However, the methods used to adjust for the effects of individual characteristics in the various studies are not clear.…”