Higher rate of hypertension in areas with greater social needs

September 10, 2024

Source: Blazel, et al JAMA Network Open August 23, 2024 LINK
Quintile 1 means patients lived in the most socioeconomically advantaged areas,
and Quintile 5 means people lived in the most disadvantaged areas.

Researchers reviewed electronic medical records from over 56,000 patients ages 35-50 treated in Cuyahoga County (Cleveland, OH), and correlated the area deprivation index of where they lived (by census tract, which is much more granular than zip code) with their likelihood of having high blood pressure. High blood pressure was defined by a diagnosis of hypertension (not by actual blood pressure reading), and between 60-67% of those diagnosed with hypertension were given a prescription. The researchers found high blood pressure much more common among Black patients. Coronary artery disease and type 2 diabetes were over three times as common in those who lived in Quintile 5.

The researchers note that decreasing systolic blood pressure by 10 mm Hg can reduce the risk of a cardiovascular event by 20% to 30%.

Implications for employers:

• High blood pressure is very common, and appropriate treatment of high blood pressure can prevent heart attacks and strokes.

• Those who live in economically depressed neighborhoods or who are people of color are most likely to need treatment for high blood pressure.

• Value based insurance design, which can waive cost-sharing for hypertension medications, could increase health equity.

• Employers can publicize local resources that can improve SDOH, like FindHelp.org.

• Nutritional and lifestyle approaches can be effective to improve outcomes and should be promoted as part of comprehensive care for individuals with hypertension.

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Tomorrow: Pharmacy out-of-pocket costs went up more than insurer costs from 2007-2020