Hypertension and Hypertension-Related Disparities in Underrepresented Minorities

Hypertension and Hypertension-Related Disparities in Underrepresented Minorities
Author: Carlos J. Rodriguez
Publisher:
Total Pages:
Release: 2016
Genre: Medicine
ISBN:

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Racial-ethnic disparities in cardiovascular disease (CVD) have been evident over the past few decades. As such, addressing these disparities have been a part of national programs such as Health People 2020 and the Million Heart initiative. Hypertension (HTN) has been a primary focus of these initiatives due to the significant contribution of HTN as a risk factor for CVD and its role in CVD racial/ethnic disparities. HTN is common among various racial/ethnic groups, in particular non-Hispanic blacks and certain groups of Hispanics. Additionally, both non-Hispanic black and Hispanic adults have been known to have higher prevalence of poorly controlled blood pressure (BP) compared to non-Hispanic whites. Long-standing HTN leads to increased risk of end-organ damage, development of coronary heart disease, stroke, end-stage kidney disease, and increased overall CVD-specific mortality. This chapter provides an update of available data on the prevalence of HTN in various racial/ethnic groups and prevalence of awareness, treatment, and control of HTN in attempts to further demonstrate the significant role HTN plays in racial/ethnic disparities in CVD. We also discuss the most recently published HTN guidelines that has led to debate regarding the potential impact on worsening CVD disparities, through disproportionate effects on the elderly, women, and non-Hispanic blacks.

Ethnic Diversities, Hypertension and Global Cardiovascular Risk

Ethnic Diversities, Hypertension and Global Cardiovascular Risk
Author: Pietro Amedeo Modesti
Publisher: Springer
Total Pages: 319
Release: 2018-11-27
Genre: Medical
ISBN: 3319931482

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In the context of the most significant influx of migrants in European history, the objective of this book is to provide healthcare professionals with essential knowledge and skills to effectively treat and prevent cardiovascular diseases in ethnic minorities. Acknowledging that the scientific and cultural training of health professionals on the specific health needs of minority groups is still limited and likely biased, the book sheds light on the different health policies in European countries as well as epidemiologic data on cardiovascular events among migrants. In addition, it presents an in-depth analysis of potential ethnic-group-specific drivers of global cardiovascular risk within this new and challenging framework – as well as issues related to its prevention and treatment. The prevalence of hypertension, diabetes, chronic kidney disease, obesity, and metabolic syndrome is found to be higher among most minority groups than in the native population, yet their access to treatment and health services may be limited by cultural and language barriers. As health professionals are confronted with such intercultural challenges on a daily basis, specific training and dedicated publications are thus essential to accompany and foster a constructive development towards a pluralist and healthier society. This book addresses that need, offering a unique and revealing resource.

A Population-Based Policy and Systems Change Approach to Prevent and Control Hypertension

A Population-Based Policy and Systems Change Approach to Prevent and Control Hypertension
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 236
Release: 2010-08-13
Genre: Medical
ISBN: 030914809X

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Hypertension is one of the leading causes of death in the United States, affecting nearly one in three Americans. It is prevalent in adults and endemic in the older adult population. Hypertension is a major contributor to cardiovascular morbidity and disability. Although there is a simple test to diagnose hypertension and relatively inexpensive drugs to treat it, the disease is often undiagnosed and uncontrolled. A Population-Based Policy and Systems Change Approach to the Prevention and Control Hypertension identifies a small set of high-priority areas in which public health officials can focus their efforts to accelerate progress in hypertension reduction and control. It offers several recommendations that embody a population-based approach grounded in the principles of measurement, system change, and accountability. The recommendations are designed to shift current hypertension reduction strategies from an individual-based approach to a population-based approach. They are also designed to improve the quality of care provided to individuals with hypertension and to strengthen the Center for Disease Control and Prevention's leadership in seeking a reduction in the sodium intake in the American diet to meet dietary guidelines. The book is an important resource for federal public health officials and organizations, especially the Center for Disease Control and Prevention, as well as medical professionals and community health workers.

Racial /ethnic Disparities in Hypertension in United States Residents: A Cross-sectional Study of Potential Explanatory Covariates Franklin I. Opara

Racial /ethnic Disparities in Hypertension in United States Residents: A Cross-sectional Study of Potential Explanatory Covariates Franklin I. Opara
Author: Franklin I. Opara
Publisher:
Total Pages: 113
Release: 2010
Genre:
ISBN: 9781109678147

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Abstract : Racial/ethnic disparities persist in hypertension (HTN) prevalence in the United States, and African Americans are disproportionately affected. The incidence is more than two-folds in African Americans compared to Caucasians, and mortality is highest among African Americans. Understanding the risk factors in HTN and how these factors vary across racial/ethnic groups is essential to reducing the mortality among African Americans. This study examined the prevalence of HTN among a sample non-institutionalized U.S. residents (N = 30,852), assessed racial/ethnic disparities and determined factors associated with racial/ethnic variance in HTN. A cross-sectional design was used to address these aims, utilizing the National Health Interview Survey, 2003 dataset. Chi square and logistic regression techniques were employed in the data analyses. The race-nonspecific prevalence of HTN was 26.7% (N = 8,243). African Americans had the highest prevalence (35.5%), Caucasians (27.5%), and Hispanics (18.6%), p

The Impact of Social Support, Psychosocial Characteristics, and Contextual Factors on Racial Disparities in Hypertension

The Impact of Social Support, Psychosocial Characteristics, and Contextual Factors on Racial Disparities in Hypertension
Author: E. Miranda Reiter
Publisher:
Total Pages:
Release: 2014
Genre:
ISBN:

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Hypertension is a serious medical condition. Although men and women of all racial groups in the US suffer from high blood pressure, black women have the highest rates of hypertension. For instance, the age-adjusted prevalence of hypertension among black women ages 20 and over is 44.3, compared to 28.1 among white women, 40.5 among black men, and 31.1 among white men. Past research has focused on SES and behavioral factors as potential explanations for blood pressure disparities between black and white women. But, even after controlling for such factors, considerable disparities remain. The goal of this research is to examine cultural and social factors that have been shown to increase blood pressure. Specifically, I examine social support, psychosocial characteristics, and contextual factors associated with race/ethnicity and hypertension, in hopes of explaining some of the disparities in high blood pressure between black and white women. Using data from Waves I, III, and IV of the National Longitudinal Study of Adolescent Health (Add Health), I estimated a sequence of multinomial logistic regression models predicting prehypertension and hypertension in young adulthood. Cross-sectional models show that racial disparities in hypertension remain after controlling for social support, psychosocial characteristics, and contextual factors. In fact, the only covariate that substantially reduced the racial disparity in hypertension was body mass index (BMI), a fairly reliable measure of body fatness for most people. I also estimated a set of multinomial logistic regression models predicting odds of prehypertension and hypertension by adolescent and cumulative social support, as well as psychosocial, contextual, and behavioral factors. These models were included to determine if early life and/or cumulative factors and conditions would help explain racial blood pressure disparities not explained by adulthood factors. Findings show that none of the early life or cumulative social support, psychosocial, contextual, or behavioral factors helped to explain racial differences in prehypertension or hypertension. Even after controlling for these factors, black women are still 1.18 times more likely than white women to have prehypertension and over two times more likely to suffer hypertension. Indeed, my findings indicate that, of the factors included in all these models, only race, age, and BMI were significant predictors of blood pressure. Also, BMI was the only factor to explain some of the disparities between black and white women. These results are similar to other studies that have examined racial health disparities, suggesting that simply being a black woman in US society may be unhealthy. The health effects of racism, discrimination, and other sources of stress faced disproportionately by black women are not easily measured by social science research, which is possibly why racial disparities in blood pressure have yet to be explained. Future research should also explore possible epigenetic effects introduced by the health conditions experienced by previous generations, as well as the influence of prenatal and early life environments.

Separate and Unequal

Separate and Unequal
Author: Cordelia Martin-Ikpe
Publisher:
Total Pages: 0
Release: 2022
Genre: Electronic dissertations
ISBN:

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Introduction: It is estimated that hypertension accounts for 50% of the Black-white mortality disparity in the U.S. In seeking to explain this disparity, most studies highlight the role of racial residential segregation - an institutional mechanism designed to protect whites from social interaction with Blacks. Though research has unveiled a significant relationship between racial disparities in health and racial segregation, the socioeconomic characteristics of Black and white designated neighborhoods remain widely unaccounted and controlled for in disparities analysis. Objective: The objectives of this study were twofold: first, simultaneously capture the racial, spatial, and socioeconomic structure of the United States; second, control for neighborhood characteristics in the analysis of Black-white hypertension Methods: The Darden-Kamel Composite Socioeconomic Index and Index of Dissimilarity are used to simultaneously capture the racial, spatial, and socioeconomic structure of the U.S., and control for neighborhood characteristics. Analysis: A chi-square test of independence established the significance of the relationship between neighborhood high blood pressure (HBP) prevalence and neighborhood socioeconomic position (SEP). ANOVA and Tukey's HSD determined the significance of mean HBP prevalence difference across SEP. A two-proportion z test established the significance of Black-white hypertension proportional differences across SEP's 1 and 5. Finally, binomial regression coefficients at each level of SEP were compared to determine the significance of race/ethnicity a predictor of hypertension at each level of SEP. Results: After controlling for neighborhood SEP and adjusting for the interaction between race and sex predictors, regression analysis revealed that race/ethnicity is a statistically insignificant predictor of hypertension at each level of SEP.