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

1 Citation (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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