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Effect of Race and Ethnicity on Antihypertensive Medication Utilization Among Women in the United States: Study of Women's Health Across the Nation (SWAN)

Year: 2017
Type: article
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 β-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.
DOI: 10.1161/jaha.116.004758
Authors: 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
Institutions: Brigham and Women's Hospital, Albert Einstein College of Medicine, Harvard University, University of Pittsburgh, University of Washington, University of Michigan, Michigan Medicine, Kaiser Permanente Northern California, Kaiser Permanente
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $3,810
Funders: Massachusetts General Hospital, University of Pittsburgh, Rush University, New England Research Institutes, National Institutes of Health, University of California, Los Angeles, University of California, Davis, National Institute on Aging, National Institute of Nursing Research
Awards: G1078949291, Study of Women's Health Across the Nation (SWAN) V: UCLA Site, Study of Women's Health Across the Nation (SWAN) V: Chicago site, G1650445419, Study of Women's Health Across the Nation (SWAN): New Jersey, G2886598935, Study of Women's Health Across the Nation (SWAN) V: Coordinating Center, G3307156501, Study of Women's Health Across the Nation (SWAN) V: Central Laboratory, G4492651742, Study of Women's Health Across the Nation (SWAN V): Michigan Site, Study of Women's Health Across the Nation(SWAN) V: Pittsburgh
OpenAlex ID: W2589537014
FWCI: 0.724
Cites: 35
Cited by: 9
Related to: 10