Abstract 009: Incidence of Hypertension among Diverse US Hispanics/Latinos: Findings from the Hispanic Community Health Study/Study of Latinos
Authors: Elfassy Tali , Cai Jianwen , Baldoni Pedro , Llabre Maria M , Zeki Al Hazzouri Adina , Raij Leopoldo , Daviglus Martha , Lash James P , Talavera Gregory A , Castaneda Sheila , Garcia Melawhy , Smoller Sylvia , Schneiderman Neil 
Published: July 2021

Introduction:
Hypertension (HTN) is a major contributor to cardiovascular disease, the leading cause of death in the US. Yet, among diverse US Hispanics/Latinos, one of the fastest growing ethnic minority populations in the US, incident rates of HTN are currently unknown.

Objectives:
To determine rates of incident HTN over six years among diverse US Hispanics/Latinos and evaluate whether rates differed by Hispanic/Latino background.

Methods:
The Hispanic Community Health Study/Study of Latinos is an ongoing prospective population-based study of 16,415 diverse Hispanics/Latinos, ages 18-74 years, from four US communities sampled through a stratified multi-stage area probability design. Baseline examination was conducted in 2008-2011. Systolic and diastolic blood pressure (BP), as the average of three seated measurements, was measured at baseline and at an ongoing second visit (2014-2017). At each visit, HTN was defined as systolic BP ≥ 140 mmHg, diastolic BP ≥ 90 mmHg, or use of anti HTN medication. This analysis includes 7,258 adults who were free of HTN at baseline and attended the second study visit by August, 2
nd
, 2017. Age adjusted, sex stratified, HTN incidence rates (IR) were calculated in person-years (PY) by Hispanic/Latino background. All analyses were weighted by nonresponse adjusted, trimmed, and calibrated sampling weights and took into account the complex survey design.

Results:
At baseline, age distributions were similar for men and women with: 40% age 18-34, 38% age 35-49, and 22% age 50 - 74; mean follow-up time was 5.7 years. Among 2,694 men, a total of 539 developed HTN for an overall age-adjusted IR of 25.7/1,000PY (95% CI: 22.8, 28.9). Among men, compared with Mexican background (IR: 20.5, 95% CI: 16.6, 25.2), the age adjusted IR of HTN per 1,000 PY was higher among Hispanics/Latinos of Dominican (IR: 39.2, 95% CI: 28.4, 54.0; p<0.01) and Cuban (IR: 30.6, 95% CI: 25.2, 37.2; p<0.01) background, but comparable among Central American (IR: 19.7, 95% CI: 14.1, 27.6; p=0.86), Puerto Rican (IR: 28.3, 95% CI: 20.5, 39.0; p=0.09), and South American (IR: 18.8, 95% CI: 11.5, 30.7; p=0.75) background. Among 4,564 women, a total of 855 developed HTN for an overall age-adjusted IR of 25.6/1,000PY (95% CI: 23.1, 28.3). Among women, compared with Mexican background (IR: 20.1, 95% CI: 17.0, 23.8), the age adjusted IR of HTN per 1,000 PY was higher among Hispanic/Latinos of Dominican (IR: 32.7, 95% CI: 24.3, 44.1; p<0.01), Cuban (IR: 26.8, 95% CI: 21.3, 33.6; p<0.05), and Puerto Rican (IR: 35.1, 95% CI: 27.4, 45.1; p<0.01) background, and comparable among Central American (IR: 23.2, 95% CI: 18.4, 29.3; p=0.31) and South American (IR: 24.3, 95% CI: 18.5, 31.8; p=0.24) background.

Conclusions:
Among a large sample of US Hispanics/Latinos free of HTN, age adjusted IRs of hypertension differed substantially by Hispanic/Latino background, being highest among those of Caribbean background.