EHR Data Reveal Striking Racial, Ethnic Disparities in Hypertension

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When investigators for Kaiser Permanente’s research arm wanted to examine what is driving racial and ethnic differences in hypertension rates, they turned to the institution’s sprawling supply of electronic health records (EHR). There, they combed through data from more than 4 million patients, aiming to explore the prevalence of the condition among and racially, ethnically, and regionally diverse group, and whether it varied by weight and neighborhood education.

What researchers found: People who are African American, American Indian or native Alaskan, Asian, native Hawaiian, or from another Pacific Islander background are much more likely to develop hypertension than people who are white or Hispanic—even if they live in neighborhoods with similar education levels or are in the same weight category, according to the resultant study, published in The Journal of Clinical Hypertension.

African Americans, native Hawaiians, and other Pacific Islanders were 2 times more likely than whites to develop the condition, a finding that remained consistent across nearly all weight categories and all community education levels, according to the study. Asians, meanwhile, saw 50% greater odds of dealing with high blood pressure than whites of the same weight.

“This research shines new light on how pervasive the racial/ethnic disparities are in hypertension,” Deborah Rohm Young, PhD, the study’s lead author and a Kaiser Permanente investigator, said in a statement. “Results from this study may provide information that could lead to better targeting of interventions to reduce hypertension, not only by race/ethnicity but possibly by weight category or social economic status.”

Kaiser Permanente had access to data from 10 health systems, encompassing 4,060,585 overweight or obese adults, whose EHR information was stored in the Patient Outcomes Research to Advance Learning network, spanning California, Colorado, Washington, DC, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington, Minnesota, and Wisconsin, according to the study.

In total, nearly 40% of patients had received a diagnosis of hypertension, researchers learned. Each higher weight level represented a prevalence increase of 5 to 10%, they noted.

“We see from the results of this research that maintaining a lower weight remains a key factor in preventing hypertension, regardless of race and ethnicity,” Michael A. Horberg, MD, who heads Kaiser Permanente’s mid-Atlantic research division, said in a statement. He called for more research into contributing factors to hypertension.

Although the disconnect between racial and ethnic groups has been known for some time, the new report revealed possible insights about what’s not causing the divide.

The researchers noted that hypertension is among the “most important modifiable risk factors for cardiovascular disease and stroke.”

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