Skip to main content
SpringerLink
Log in

Racial and ethnic disparity in blood pressure and cholesterol measurement

  • Original Articles
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

OBJECTIVE: To evaluate racial and ethnic disparity in blood pressure and cholesterol measurement and to analyze factors associated with any observed disparity.

DESIGN: Cross-sectional analysis of the household component of the 1996 Medical Expenditure Panel Survey.

PARTICIPANTS: Representative sample of the U.S. non-institutionalized population age 21 or older.

MEASUREMENTS: Prevalence of self-reported blood pressure measurement within 2 years and cholesterol measurement within 5 years were calculated by race/ethnicity. Logistic regression was used to adjust for health insurance status, having a usual source of care, health status, and socioeconomic and demographic factors. Odds ratios and 95% confidence intervals (95% CIs) from the logistic regression were converted to prevalence ratios to estimate relative risk (RR).

MAIN RESULTS: Mexican Americans compared to non-Hispanic whites were less likely to have a blood pressure measurement (RR, 0.85; 95% CI, 0.81 to 0.89) or a cholesterol measurement (RR, 0.72; 95% CI, 0.65 to 0.78). Non-Hispanic blacks had blood pressure and cholesterol measurements similar to non-Hispanic whites. In a multivariate analysis, Mexican Americans had similar blood pressure measurements (RR, 0.97; 95% CI, 0.94 to 1.00) and cholesterol measurements (RR, 1.04; 95% CI, 0.99 to 1.08). The factors associated with the largest disparity were lack of health insurance, not having a usual source of care, and low education.

CONCLUSIONS: No disparity was found between non-Hispanic blacks and non-Hispanic whites in undergoing blood pressure and cholesterol measurement. Disparities in cardiovascular preventive services for Mexican Americans were associated with lack of health insurance and a usual source of care, but other demographic and socioeconomic factors were also important.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. U. S. Public Health Service. Healthy People 2010: Understanding and Improving Health. U.S. Government Printing Office stock # 017-001-00550-9. Available from: URL: http://www.health.gov/healthypeople.

  2. Carlisle DM, Leake BD, Shapiro MF. Racial and ethnic disparities in the use of cardiovascular procedures: associations with type of insurance. Am J Public Health. 1997;87:263–7.

    PubMed  CAS  Google Scholar 

  3. Kass BL, Weinick RN, Monheit AC. Racial and ethnic differences in health, 1996. Rockville, Md: Agency for Health Care Policy and Research; 1999. MEPS Chartbook No. 2. AHCPR Publication No. 99-0001.

    Google Scholar 

  4. Kahn KL, Pearson ML, Harrison ER, et al. Health care for black and poor hospitalized Medicare patients. JAMA. 1994;271:1169–74.

    Article  PubMed  CAS  Google Scholar 

  5. Whittle J, Conigliaro J, Good CB, Lofgren RP. Racial differences in the use of invasive cardiovascular procedures in the Department of Veteran’s Affairs medical system. N Engl J Med. 1993;329:621–7.

    Article  PubMed  CAS  Google Scholar 

  6. Ayanian JZ, Udvarhelyi IS, Gatsonis CA, Pashos CL, Epstein AM. Racial differences in the use of revascularization procedures after coronary angiography. JAMA. 1993;269:2642–6.

    Article  PubMed  CAS  Google Scholar 

  7. US Public Health Service. Healthy People 2010: Objectives for Improving Health, Part A, Focus Area 12, Heart Disease and Stroke, 2nd ed, vol. 1. U.S. Government Printing Office stock # 017-001-00547-9. Available from URL:http://www.health.gov/healthypeople/Document/HTML/Volume/12Heart.htm#_Toc471819933.

  8. Cohen JW, Monheit AC, Beauregard KM, et al. The Medical Expenditure Panel Survey: a national health information resource. Inquiry. 1996;33:373–89.

    PubMed  Google Scholar 

  9. Zhang J, Yu KF. What’s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. JAMA. 1998;280:1690–1.

    Article  PubMed  CAS  Google Scholar 

  10. Bolen JC, Rhodes L, Powell-Griner EE, Bland SD, Holtzman D. State-specific prevalence of selected health behaviors, by race and ethnicity-behavioral risk factor surveillance system, 1997. Mor Mortal Wkly Rep. 2000;49:1–60.

    CAS  Google Scholar 

  11. Srinivasan S, Guillermo T. Toward improved health: disaggregating Asian American and Native Hawaiian/Pacific Islander data. Am J Public Health. 2000;90:1731–4.

    Article  PubMed  CAS  Google Scholar 

  12. Atkins D, DiGiuseppi C. Screening for high blood cholesterol and other lipid abnormalities. In: U.S. Preventive Services Task Force Guide to Clinical Preventive Services. 2nd ed. Baltimore, Md: Williams and Wilkins; 1996:15.

    Google Scholar 

  13. National Cholesterol Education Program. Second report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Bethesda, Md: National Heart, Lung, and Blood Institute, National Institutes of Health: 1993. (Publication 93-3095). Available from URL/: http://www.nhlbi.nih.gov/guidelines cholesterol/atp_ii.htm.

  14. American College of Physicians. Serum cholesterol, high density lipoprotein cholesterol, and triglycerides screening tests for the prevention of coronary heart disease in adults. Ann Intern Med. 1996;124:518–31.

    Google Scholar 

  15. Stamler J, Daviglus M, Garside DB, Dyer AR, Greenland P, Neaton JD. Relationship of baseline serum cholesterol levels in 3 large cohorts of younger men to long-term coronary, cardiovascular, and all-cause mortality and to longevity. JAMA. 2000;284:311–8.

    Article  PubMed  CAS  Google Scholar 

  16. Kjekshus J, Pedersen TR. Reducing the risk of coronary events: evidence from the Scandanavian Simvistatin Survival Study (4S). Am J Cardiol. 1995;76:64C-8C.

    Article  PubMed  CAS  Google Scholar 

  17. Shepard J, Cobbe SM, Ford I, et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Coronary Prevention Study Group. N Engl J Med. 1995;333:1301–7.

    Article  Google Scholar 

  18. Lenfant C, Savage PJ. The early natural history of atherosclerosis and hypertension in the young: National Institutes of Health perspectives. Am J Med Sci. 1995; 310(suppl 1):3–7.

    Google Scholar 

  19. McGill HC, McMahan CA, Zieske AW, et al. Associations of coronary heart disease risk factors with the intermediate lesion of atherosclerosis in youth. The Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. Arterioscler Thromb Vasc Biol. 2000;20:1998–2004.

    PubMed  Google Scholar 

  20. Mangione CM, Reynolds E. Disparities in health and healthcare: moving from describing the problem to a call for action. J Gen Intern Med. 2000;16:276–80.

    Article  Google Scholar 

  21. Martin LM, Leff M, Calonge N, Garrett C. Nelson DE. Validation of self-reported chronic conditions and health services in a managed care population. Am J Prev Med. 2000;18:215–8.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Received from the Division of General Internal Medicine and the Center for Health Care Research, Medical University of South Carolina, Charleston, SC

    Scott H. Stewart MD & Marc D. Silverstein MD

Authors
  1. Scott H. Stewart MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marc D. Silverstein MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Scott H. Stewart MD.

Additional information

Dr. Stewart was an Academic Generalist Fellow at the Medical University of South Carolina, and received support from a Health Research Service Administration educational grant (No. 1 D08 HP 50101) during the completion of this project.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stewart, S.H., Silverstein, M.D. Racial and ethnic disparity in blood pressure and cholesterol measurement. J GEN INTERN MED 17, 405–411 (2002). https://doi.org/10.1046/j.1525-1497.2002.10524.x

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1046/j.1525-1497.2002.10524.x

Key Words

Search

Navigation