Treatment of High Cholesterol and High Blood Pressure among Hispanic People Living in Rural and Urban Areas of the United States.

Abstract

Cardiovascular disease (CVD) is the leading cause of death in the United States, with people who identify as Hispanic having a higher prevalence of diabetes and lower rates of hypertension control, showing disparities in access to treatment depending on the region and the differences across urban and rural areas across the US. The objective of this study was to examine the differences in blood pressure and cholesterol treatment rates among Hispanic individuals in the US to better explain geographic variation in CVD outcomes. We analyzed the data from the 2023 Behavioral Risk Factor Surveillance System (BRFSS), which includes Hispanic respondents who self-reported having high blood pressure and/or high cholesterol. We used the complex sampling methods of the BRFSS in order to better weight our data and determine more precise results. And being able to create the Unadjusted, Adjusted, Effect modification, and Interaction models. A total of 38,390 Hispanic respondents were included in this study. People living in rural areas had a similar prevalence of self-reported high blood pressure (27.3% rural vs. 25.8% urban, p=0.44), but, contrary to our hypothesis, they were more likely to report being treated for high blood pressure compared to those living in urban areas (73% rural vs. 66.9% urban, p=0.03). In the unadjusted model, the odds of treatment for high blood pressure was ~30% higher in rural vs. urban respondents, though the effect was not statistically significant [OR 1.32 (95% CI 0.97-1.79), p=0.08]. For cholesterol, the odds of treatment were also ~30% higher for rural respondents compared to urban respondents [OR 1.32 (95% CI 1.03-1.69), p=0.03]. Adjusting for age, gender, and education did not affect the odds of blood pressure treatment for rural vs. urban respondents [OR 1.32 (95%CI 0.91-1.92), p=0.14], but did partially attenuate the rural-urban difference in cholesterol treatment [OR 1.19 (95%CI 0.88-1.62), P-value=0.26]. Our study did not demonstrate any rural-urban disparities in self-reported blood pressure and cholesterol treatment among Hispanic people. Larger, adequately powered studies are needed to confirm any rural-urban disparities in cardiovascular risk factor management in this population.