Prevalence of hypertension increases with neighborhood disadvantage

The prevalence of hypertension increases with neighborhood disadvantage, according to a study published online Aug. 23 in JAMA Network Open.

Madeleine M. Blazel, from the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, and colleagues examined spatial patterns of hypertension diagnosis and treatment by neighborhood socioeconomic position and racial and ethnic composition. Geocoded electronic health record data were linked to the area deprivation index (ADI) at the U.S. Census Block Group level (neighborhood).

Data were analyzed for 56,387 adults across 1,157 neighborhoods. The researchers observed a gradient of hypertension prevalence across ADI quintiles, with a higher hypertension rate for the highest versus lowest ADI quintile neighborhoods (50.7 versus 25.5 percent) and lower treatment rate (61.3 versus 64.5 percent). Sixty-three percent of the 315 neighborhoods with predominantly Black patient populations (>75 percent) had a hypertension rate greater than 35 percent and a treatment rate less than 70 percent; only 11.8 percent of the 263 neighborhoods with ≤5 percent Black patient populations met this same criterion.

Overall, 91 and 98 percent of the variation in hypertension prevalence among women and men, respectively, was accounted for by inclusion of ADI and percentage of Black patients compared with a spatial model without covariates. Across race and ADI quintiles, men had a higher prevalence of hypertension than women; the association of ADI and hypertension risk was stronger in women.

“The findings of this cross-sectional study suggest stark racial and neighborhood disparities in hypertension prevalence and antihypertensive treatment among adults in midlife,” the authors write.

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