| Autor: |
Meyerovitz CV; UMass Chan Medical School Worcester MA., Juraschek SP; Division of General Medicine Beth Israel Deaconess Medical Center/Harvard Medical School Boston MA., Ayturk D; Department of Population and Quantitative Health Sciences UMass Chan Medical School Worcester MA., Moore Simas TA; Department of Population and Quantitative Health Sciences UMass Chan Medical School Worcester MA.; Departments of Obstetrics and Gynecology, Pediatrics and Psychiatry UMass Chan Medical School Worcester MA., Person SD; Department of Population and Quantitative Health Sciences UMass Chan Medical School Worcester MA., Lemon SC; Department of Population and Quantitative Health Sciences UMass Chan Medical School Worcester MA., McManus DD; Division of Cardiovascular Medicine, Department of Medicine UMass Chan Medical School Worcester MA., Kovell LC; Division of Cardiovascular Medicine, Department of Medicine UMass Chan Medical School Worcester MA. |
| Abstrakt: |
Background Hypertension is an important modifiable risk factor of serious maternal morbidity and mortality. Social determinants of health (SDoH) influence hypertension outcomes and may contribute to racial and ethnic differences in hypertension control. Our objective was to assess SDoH and blood pressure (BP) control by race and ethnicity in US women of childbearing age with hypertension. Methods and Results We studied women (aged 20-50 years) with hypertension (systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg or use of antihypertensive medication) in the National Health and Nutrition Examination Surveys 2001 to 2018. SDoH and BP control (systolic BP <140 mm Hg and diastolic BP <90 mm Hg) were examined by race and ethnicity (White race, Black race, Hispanic ethnicity, and Asian race). Using multivariable logistic regression, odds of uncontrolled BP by race and ethnicity were modeled, adjusting for SDoH, health factors, and modifiable health behaviors. Responses on hunger and affording food determined food insecurity status. Across women of childbearing age with hypertension (N=1293), 59.2% were White race, 23.4% were Black race, 15.8% were Hispanic ethnicity, and 1.7% were Asian race. More Hispanic and Black women experienced food insecurity than White women (32% and 25% versus 13%; both P <0.001). After SDoH, health factor, and modifiable health behavior adjustment, Black women maintained higher odds of uncontrolled BP than White women (odds ratio, 2.31 [95% CI, 1.08-4.92]), whereas Asian and Hispanic women showed no difference. Conclusions We identified racial inequities in uncontrolled BP and food insecurity among women of childbearing age with hypertension. Further exploration beyond the SDoH measured is needed to understand the inequity in hypertension control in Black women. |
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