Effect of race and ethnicity on antihypertensive medication utilization among women in the United States: Study of Women'S Health Across the Nation (SWAN)

Elizabeth A. Jackson, Kristine Ruppert, Carol A. Derby, Yinjuan Lian, Genevieve Neal-Perry, Laurel A. Habel, Ping G. Tepper, Siobán D. Harlow, Daniel H. Solomon

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background-Antihypertensive medication use may vary by race and ethnicity. Longitudinal antihypertensive medication use patterns are not well described in women. Methods and Results-Participants from the Study of Women's Health Across the Nation (SWAN), a prospective cohort of women (n = 3302, aged 42-52), who reported a diagnosis of hypertension or antihypertensive medication use at any annual visit were included. Antihypertensive medications were grouped by class and examined by race/ethnicity adjusting for potential confounders in logistic regression models. A total of 1707 (51.7%) women, mean age 50.6 years, reported hypertension or used antihypertensive medications at baseline or during follow-up (mean 9.1 years). Compared with whites, blacks were almost 3 times as likely to receive a calcium channel blocker (odds ratio, 2.92; 95% CI, 2.24-3.82) and twice as likely to receive a thiazide diuretic (odds ratio, 2.38; 95% CI, 1.93-2.94). Blacks also had a higher probability of reporting use of ≥ 2 antihypertensive medications (odds ratio, 1.95; 95% CI, 1.55-2.45) compared with whites. Use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and thiazide diuretics increased over time for all racial/ethnic groups. Contrary to our hypothesis, rates of b-blocker usage did not decrease over time. Conclusions-Among this large cohort of multiethnic midlife women, use of antihypertensive medications increased over time, with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers becoming the most commonly used antihypertensive medication, even for blacks. Thiazide diuretic utilization increased over time for all race/ethnic groups as did use of calcium channel blockers among blacks; both patterns are in line with guideline recommendations for the management of hypertension.

Original languageEnglish (US)
Article numbere004758
JournalJournal of the American Heart Association
Volume6
Issue number3
DOIs
StatePublished - 2017

Fingerprint

Women's Health
Antihypertensive Agents
Sodium Chloride Symporter Inhibitors
Angiotensin Receptor Antagonists
Odds Ratio
Calcium Channel Blockers
Hypertension
Ethnic Groups
Angiotensin-Converting Enzyme Inhibitors
Logistic Models
Guidelines

Keywords

  • Disparities
  • Hypertension
  • Medication
  • Race/ethnicity
  • Women

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Effect of race and ethnicity on antihypertensive medication utilization among women in the United States : Study of Women'S Health Across the Nation (SWAN). / Jackson, Elizabeth A.; Ruppert, Kristine; Derby, Carol A.; Lian, Yinjuan; Neal-Perry, Genevieve; Habel, Laurel A.; Tepper, Ping G.; Harlow, Siobán D.; Solomon, Daniel H.

In: Journal of the American Heart Association, Vol. 6, No. 3, e004758, 2017.

Research output: Contribution to journalArticle

Jackson, Elizabeth A. ; Ruppert, Kristine ; Derby, Carol A. ; Lian, Yinjuan ; Neal-Perry, Genevieve ; Habel, Laurel A. ; Tepper, Ping G. ; Harlow, Siobán D. ; Solomon, Daniel H. / Effect of race and ethnicity on antihypertensive medication utilization among women in the United States : Study of Women'S Health Across the Nation (SWAN). In: Journal of the American Heart Association. 2017 ; Vol. 6, No. 3.
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abstract = "Background-Antihypertensive medication use may vary by race and ethnicity. Longitudinal antihypertensive medication use patterns are not well described in women. Methods and Results-Participants from the Study of Women's Health Across the Nation (SWAN), a prospective cohort of women (n = 3302, aged 42-52), who reported a diagnosis of hypertension or antihypertensive medication use at any annual visit were included. Antihypertensive medications were grouped by class and examined by race/ethnicity adjusting for potential confounders in logistic regression models. A total of 1707 (51.7{\%}) women, mean age 50.6 years, reported hypertension or used antihypertensive medications at baseline or during follow-up (mean 9.1 years). Compared with whites, blacks were almost 3 times as likely to receive a calcium channel blocker (odds ratio, 2.92; 95{\%} CI, 2.24-3.82) and twice as likely to receive a thiazide diuretic (odds ratio, 2.38; 95{\%} CI, 1.93-2.94). Blacks also had a higher probability of reporting use of ≥ 2 antihypertensive medications (odds ratio, 1.95; 95{\%} CI, 1.55-2.45) compared with whites. Use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and thiazide diuretics increased over time for all racial/ethnic groups. Contrary to our hypothesis, rates of b-blocker usage did not decrease over time. Conclusions-Among this large cohort of multiethnic midlife women, use of antihypertensive medications increased over time, with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers becoming the most commonly used antihypertensive medication, even for blacks. Thiazide diuretic utilization increased over time for all race/ethnic groups as did use of calcium channel blockers among blacks; both patterns are in line with guideline recommendations for the management of hypertension.",
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AU - Derby, Carol A.

AU - Lian, Yinjuan

AU - Neal-Perry, Genevieve

AU - Habel, Laurel A.

AU - Tepper, Ping G.

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AU - Solomon, Daniel H.

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N2 - Background-Antihypertensive medication use may vary by race and ethnicity. Longitudinal antihypertensive medication use patterns are not well described in women. Methods and Results-Participants from the Study of Women's Health Across the Nation (SWAN), a prospective cohort of women (n = 3302, aged 42-52), who reported a diagnosis of hypertension or antihypertensive medication use at any annual visit were included. Antihypertensive medications were grouped by class and examined by race/ethnicity adjusting for potential confounders in logistic regression models. A total of 1707 (51.7%) women, mean age 50.6 years, reported hypertension or used antihypertensive medications at baseline or during follow-up (mean 9.1 years). Compared with whites, blacks were almost 3 times as likely to receive a calcium channel blocker (odds ratio, 2.92; 95% CI, 2.24-3.82) and twice as likely to receive a thiazide diuretic (odds ratio, 2.38; 95% CI, 1.93-2.94). Blacks also had a higher probability of reporting use of ≥ 2 antihypertensive medications (odds ratio, 1.95; 95% CI, 1.55-2.45) compared with whites. Use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and thiazide diuretics increased over time for all racial/ethnic groups. Contrary to our hypothesis, rates of b-blocker usage did not decrease over time. Conclusions-Among this large cohort of multiethnic midlife women, use of antihypertensive medications increased over time, with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers becoming the most commonly used antihypertensive medication, even for blacks. Thiazide diuretic utilization increased over time for all race/ethnic groups as did use of calcium channel blockers among blacks; both patterns are in line with guideline recommendations for the management of hypertension.

AB - Background-Antihypertensive medication use may vary by race and ethnicity. Longitudinal antihypertensive medication use patterns are not well described in women. Methods and Results-Participants from the Study of Women's Health Across the Nation (SWAN), a prospective cohort of women (n = 3302, aged 42-52), who reported a diagnosis of hypertension or antihypertensive medication use at any annual visit were included. Antihypertensive medications were grouped by class and examined by race/ethnicity adjusting for potential confounders in logistic regression models. A total of 1707 (51.7%) women, mean age 50.6 years, reported hypertension or used antihypertensive medications at baseline or during follow-up (mean 9.1 years). Compared with whites, blacks were almost 3 times as likely to receive a calcium channel blocker (odds ratio, 2.92; 95% CI, 2.24-3.82) and twice as likely to receive a thiazide diuretic (odds ratio, 2.38; 95% CI, 1.93-2.94). Blacks also had a higher probability of reporting use of ≥ 2 antihypertensive medications (odds ratio, 1.95; 95% CI, 1.55-2.45) compared with whites. Use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and thiazide diuretics increased over time for all racial/ethnic groups. Contrary to our hypothesis, rates of b-blocker usage did not decrease over time. Conclusions-Among this large cohort of multiethnic midlife women, use of antihypertensive medications increased over time, with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers becoming the most commonly used antihypertensive medication, even for blacks. Thiazide diuretic utilization increased over time for all race/ethnic groups as did use of calcium channel blockers among blacks; both patterns are in line with guideline recommendations for the management of hypertension.

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KW - Hypertension

KW - Medication

KW - Race/ethnicity

KW - Women

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