Uncontrolled BP twice as likely in Black vs. white women with hypertension
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Black women aged 20 to 50 years with hypertension are more than twice as likely to have uncontrolled BP compared with white women, independent of social determinants of health and modifiable health behaviors, researchers reported.
In an analysis of more than 1,200 women who participated in the National Health and Nutrition Examination Survey, researchers also found that food insecurity was highly prevalent among Black and Hispanic women of childbearing age with hypertension, further increasing risk for maternal morbidity during and after pregnancy.
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“Although high blood pressure is a treatable, common chronic health condition, it is a leading cause of pregnancy-related deaths and severe disease,” Lara C. Kovell, MD, a cardiologist at the University of Massachusetts Chan Medical School in Worcester, said in a press release. “The United States has much higher rates of pregnancy-related deaths than economically similar countries, and Black women are disproportionately affected.”
Kovell and colleagues analyzed data from 1,293 women aged 20 to 50 years with a diagnosis of hypertension, defined as a BP of at least 140/90 mm Hg (mean age, 36 years), who participated in NHANES between 2001 and 2018. Researchers assessed social determinants of health and BP control by race, estimating the odds of uncontrolled BP by race and ethnicity before and after adjusting for social determinants of health, health factors and modifiable health behaviors. Researchers assessed food insecurity via responses to questions about hunger and affording food.
The findings were published in the Journal of the American Heart Association.
Within the cohort, 59.2% identified as white, 23.4% identified as Black, 15.8% identified as Hispanic and 1.7% identified as Asian.
After adjusting for social determinants of health, health factors and modifiable health behaviors, Black women were 2.3 times more likely to have uncontrolled BP compared with white women (OR = 2.31; 95% CI, 1.08-4.92). There were no differences in uncontrolled BP rates when comparing white women with Asian and Hispanic women.
Black and Hispanic women had higher rates of food insecurity (32% and 25%, respectively) than white women (13%; P < .001).
“Food insecurity is important when thinking about high blood pressure, since sodium levels are higher in many lower-cost food options such as canned, ultra-processed fast foods,” Kovell said in the release. “Moreover, food insecurity and a lack of access to healthy foods have been shown in other studies to increase the risk of high blood pressure.”
In the release, Kovell said questions about food insecurity and health care access should be included in the standard screening questions at hospital or clinic visits, especially for pregnant patients.
Reference:
- Black women of childbearing age more likely to have high blood pressure, raising pregnancy risks. https://newsroom.heart.org/news/black-women-of-childbearing-age-more-likely-to-have-high-blood-pressure-raising-pregnancy-risks. Published Feb. 27, 2023. Accessed Feb. 27, 2023.
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