The Association between Hypertension and Race/Ethnicity among Breast Cancer Survivors

Abstract

Purpose: Hypertension is a significant, modifiable risk factor for cardiovascular disease (CVD). African American women who are diagnosed with early-stage breast cancer have a significantly higher risk of premature death due to CVD. The purpose of this study was to examine the association between hypertension and race/ethnicity among breast cancer survivors using data from the National Health and Nutrition Examination Surveys 1999-2014.

Methods: Non-Hispanic African American and non-Hispanic White women who were diagnosed with breast cancer were identified. Hypertension was defined as taking medication to treat hypertension, having a systolic blood pressure ≥ 140, or a diastolic blood pressure ≥ 90. Modified Poisson regression was performed to estimate the prevalence ratios (PR) and corresponding 95% confidence intervals (CI) for race/ethnicity, as it relates to hypertension controlling for potential confounders.

Results: Of the 524 breast cancer survivors included in our study, 107 (20.4%) were African American and 417 (80.0%) were White. After adjusting for age, marital status, education, annual household income, health insurance, smoking and drinking status, physical inactivity, obesity, and diabetes, African American breast cancer survivors had a 30% higher prevalence of hypertension (PR = 1.30 [95% CI, 1.11-1.52]) than White breast cancer survivors.

Conclusions: These results indicate that African American breast cancer survivors have a significantly higher risk of CVD due to hypertension even after controlling for other comorbid conditions such as diabetes and obesity.

Keywords: Breast cancer survivor; Health disparities; Hypertension.