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Heat Maps of Hypertension, Diabetes Mellitus, and Smoking in the Continental United States.

TitleHeat Maps of Hypertension, Diabetes Mellitus, and Smoking in the Continental United States.
Publication TypeJournal Article
Year of Publication2017
AuthorsLoop, MShane, Howard, G, Campos, Gde Los, Al-Hamdan, MZ, Safford, MM, Levitan, EB, McClure, LA
JournalCirc Cardiovasc Qual Outcomes
Date Published2017 01
KeywordsAfrican Americans, Age Distribution, Aged, Cardiovascular Diseases, Cluster Analysis, Cross-Sectional Studies, Diabetes Mellitus, European Continental Ancestry Group, Female, Health Status Disparities, Humans, Hypertension, Logistic Models, Male, Middle Aged, Odds Ratio, Prevalence, Risk Assessment, Risk Factors, Sex Distribution, Smoking, Time Factors, United States

BACKGROUND: Geographic variations in cardiovascular mortality are substantial, but descriptions of geographic variations in major cardiovascular risk factors have relied on data aggregated to counties. Herein, we provide the first description of geographic variation in the prevalence of hypertension, diabetes mellitus, and smoking within and across US counties.METHODS AND RESULTS: We conducted a cross-sectional analysis of baseline risk factor measurements and latitude/longitude of participant residence collected from 2003 to 2007 in the REGARDS study (Reasons for Geographic and Racial Differences in Stroke). Of the 30 239 participants, all risk factor measurements and location data were available for 28 887 (96%). The mean (±SD) age of these participants was 64.8(±9.4) years; 41% were black; 55% were female; 59% were hypertensive; 22% were diabetic; and 15% were current smokers. In logistic regression models stratified by race, the median(range) predicted prevalence of the risk factors were as follows: for hypertension, 49% (45%-58%) among whites and 72% (68%-78%) among blacks; for diabetes mellitus, 14% (10%-20%) among whites and 31% (28%-41%) among blacks; and for current smoking, 12% (7%-16%) among whites and 18% (11%-22%) among blacks. Hypertension was most prevalent in the central Southeast among whites, but in the west Southeast among blacks. Diabetes mellitus was most prevalent in the west and central Southeast among whites but in south Florida among blacks. Current smoking was most prevalent in the west Southeast and Midwest among whites and in the north among blacks.CONCLUSIONS: Geographic disparities in prevalent hypertension, diabetes mellitus, and smoking exist within states and within counties in the continental United States, and the patterns differ by race.

Alternate JournalCirc Cardiovasc Qual Outcomes
PubMed ID28073852
PubMed Central IDPMC5234692
Grant ListR01 HL080477 / HL / NHLBI NIH HHS / United States
T32 HL007457 / HL / NHLBI NIH HHS / United States
T32 HL079888 / HL / NHLBI NIH HHS / United States
U01 NS041588 / NS / NINDS NIH HHS / United States