title: Factors associated with the prevalence of hypertension in the southeastern United States: insights from 69,211 blacks and whites in the Southern Community Cohort Study.
abstract: BACKGROUND
  Lifestyle and socioeconomic status have been implicated in the prevalence of hypertension; thus, we evaluated factors associated with hypertension in a cohort of blacks and whites with similar socioeconomic status characteristics.
  
  
  RESULTS
  We evaluated the prevalence and factors associated with self-reported hypertension (SR-HTN) and ascertained hypertension (A-HTN) among 69,211 participants in the Southern Community Cohort Study. Multivariable logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with hypertension. The prevalence of SR-HTN was 57% overall. Body mass index was associated with SR-HTN in all race-sex groups, with the OR rising to 4.03 (95% CI, 3.74-4.33) for morbidly obese participants (body mass index, >40 kg/m(2)). Blacks were more likely to have SR-HTN than whites (OR, 1.84; 95% CI, 1.75-1.93), and the association with black race was more pronounced among women (OR, 2.08; 95% CI, 1.95-2.21) than men (OR, 1.47; 95% CI, 1.36-1.60). Similar findings were noted in the analysis of A-HTN. Among those with SR-HTN and A-HTN who reported use of an antihypertensive agent, 94% were on at least one of the major classes of antihypertensive agents, but only 44% were on ≥2 classes and only 29% were on a diuretic. The odds of both uncontrolled hypertension (SR-HTN and A-HTN) and unreported hypertension (no SR-HTN and A-HTN) were twice as high among blacks as whites (OR, 2.13; 95% CI, 1.68-2.69; and OR, 1.99; 95% CI, 1.59-2.48, respectively).
  
  
  CONCLUSIONS
  Despite socioeconomic status similarities, we observed suboptimal use of antihypertensives in this cohort and racial differences in the prevalence of uncontrolled and unreported hypertension, which merit further investigation.
authors.affiliation: Department of Medicine.
authors.forename: Uchechukwu K A
authors.initials: UK
authors.lastname: Sampson
authors.forename: Todd L
authors.initials: TL
authors.lastname: Edwards
authors.forename: Eiman
authors.initials: E
authors.lastname: Jahangir
authors.forename: Heather
authors.initials: H
authors.lastname: Munro
authors.forename: Minaba
authors.initials: M
authors.lastname: Wariboko
authors.forename: Mariam G
authors.initials: MG
authors.lastname: Wassef
authors.forename: Sergio
authors.initials: S
authors.lastname: Fazio
authors.forename: George A
authors.initials: GA
authors.lastname: Mensah
authors.forename: Edmond K
authors.initials: EK
authors.lastname: Kabagambe
authors.forename: William J
authors.initials: WJ
authors.lastname: Blot
authors.forename: Loren
authors.initials: L
authors.lastname: Lipworth
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D044383:Black People / Q000208:ethnology*; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000208:ethnology*; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D015995:Prevalence; D044469:Racial Groups; D012307:Risk Factors; D012923:Social Class; D015144:Southeastern United States / Q000453:epidemiology; D044465:White People / Q000208:ethnology*; D001741:Black or African American
keywords: African Continental Ancestry Group; European Continental Ancestry Group; hypertension; prevalence