Resumen de Association Between Neighborhood Disadvantage and Hypertension Prevalence, Awareness, Treatment, and Control in Older Adults: Results From the University of Alabama at Birmingham Study of Aging.
David Buys, Virginia J. Howard, Leslie A. McClure, Katie Crawford Buys, Patricia Sawyer, Richard M. Allman, Emily B. Levitan
Objectives. We e va luated th e e ffe c t o f n e ig h b o rh o o d d isa d van ta g e (ND) on o ld e r a d u lts ' prevalence, awareness, tre a tm e n t, and c o n tro l o f h yp e rte n s io n . Methods. Data w e re from th e U n iv e rs ity o f A la b am a at B irm in g h am S tu d y o f A g in g , an o b s e rv a tio n a l s tu d y o f 1000 c om m u n ity -dw e llin g Black and W h ite A la b am ia n s aged 65 years and o ld e r, in 1999 to 2001. We assessed h yp e rte n s io n prevalence, awareness, tre a tm e n t, and c o n tro l w ith b lo o d pressure measurem e n ts and se lf-re p o rt data. We assessed ND w ith US Census data c o rre s p o n d in g w ith participants' census tracts, created tertiles o f ND, and fit models w ith generalized estimating equations via a lo g it link function w ith a binomial distribution. Adjusted models included variables assessing personal advantage and disadvantage, placebased factors, sociodemographics, comorbidities, and health behaviors. Results. L iv in g in m id -N D (adjusted o dds ra tio [AOR] = 1.6; 95% co n fid e n ce in te rva l [Cl] = 1.2, 2.1) and h ig h -N D te rtile s (AOR = 1.8; 95% Cl = 1.3, 2.3) was associated w ith h ig h e r hype rte n s io n prevalence, and liv in g in high-ND te rtile s w as associated w ith low e r o dds o f co n tro lle d h yp ertens ion (AOR = 0.6; 95% Cl = 0.4, 0.6). In adjusted models, ND was n o t associated w ith h yp ertens ion awareness o r tre a tm e n t. Conclusions. These fin d in g s s h ow th a t n e ig h b o rh o o d e n v iro nm e n ta l fa c to rs matter for hypertension outcomes and suggest the importance of ND for hypertension management in older adults. [ABSTRACT FROM AUTHOR]
