title: Prevalence, awareness, treatment, and predictors of control of hypertension in New York City.
abstract: BACKGROUND
  Hypertension-related risk in urban areas may vary from national estimates; however, objective data on prevalence and treatment in local areas are scarce. We assessed hypertension prevalence, awareness, treatment, and control among New York City (NYC) adults.
  
  
  RESULTS
  The NYC Health And Nutrition Examination Survey (HANES), modeled on the national HANES, was conducted in 2004 with a representative sample of noninstitutionalized NYC residents > or =20 years of age. Hypertension outcomes were examined with interview and examination data (n=1975). Multiple logistic regression was used to assess factors associated with control among adults with hypertension. We found that 25.6% of NYC adults had hypertension. Blacks had a higher prevalence than whites (32.8% versus 21.1%, P<0.001), as did Hispanics (26.5% versus 21.1%, P<0.05). Foreign-born residents who had lived in the United States for <10 years had lower rates than those who had lived in the United States longer (20.0% versus 27.5%, P<0.05). Among adults with hypertension, 83.0% were diagnosed, 72.7% were treated, and 47.1% had hypertension controlled. Of those treated, 64.8% had hypertension controlled. After adjustment for sociodemographic variables among all adults with treated hypertension, lack of a routine place of medical care was most strongly associated with poor control levels (adjusted odds ratio 0.21, 95% confidence interval 0.07 to 0.66). Among nonelderly adults with treated hypertension, blacks had 4-fold lower odds than whites of having hypertension controlled (adjusted odds ratio 0.24, 95% confidence interval 0.06 to 0.92).
  
  
  CONCLUSIONS
  In NYC, hypertension is common and frequently uncontrolled. Low levels of control are associated with poor access to care. Racial disparities in prevalence and control are evident among nonelderly adults.
authors.affiliation: New York City Department of Health and Mental Hygiene, New York, NY 10007, USA. sangell@health.nyc.gov
authors.forename: Sonia Y
authors.initials: SY
authors.lastname: Angell
authors.forename: Renu K
authors.initials: RK
authors.lastname: Garg
authors.forename: R Charon
authors.initials: RC
authors.lastname: Gwynn
authors.forename: Lori
authors.initials: L
authors.lastname: Bash
authors.forename: Lorna E
authors.initials: LE
authors.lastname: Thorpe
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Frieden
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D009519:New York City; D015995:Prevalence; D011379:Prognosis; D044469:Racial Groups; D019037:Urban Health Services / Q000191:economics / Q000706:statistics & numerical data