Effect of race and ethnicity on antihypertensive medication utilization among women in the United States: Study of Women'S Health Across the Nation (SWAN)

Background-antihypertensive medication use may vary by race and ethnicity. longitudinal antihypertensive medication use patterns are not well described in women. methods and results-participants from the study of women's health across the nation (swan),a prospective cohort of women (n = 3302,aged 42-52),who reported a diagnosis of hypertension or antihypertensive medication use at any annual visit were included. antihypertensive medications were grouped by class and examined by race/ethnicity adjusting for potential confounders in logistic regression models. a total of 1707 (51.7%) women,mean age 50.6 years,reported hypertension or used antihypertensive medications at baseline or during follow-up (mean 9.1 years). compared with whites,blacks were almost 3 times as likely to receive a calcium channel blocker (odds ratio,2.92; 95% ci,2.24-3.82) and twice as likely to receive a thiazide diuretic (odds ratio,2.38; 95% ci,1.93-2.94). blacks also had a higher probability of reporting use of ≥ 2 antihypertensive medications (odds ratio,1.95; 95% ci,1.55-2.45) compared with whites. use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and thiazide diuretics increased over time for all racial/ethnic groups. contrary to our hypothesis,rates of b-blocker usage did not decrease over time. conclusions-among this large cohort of multiethnic midlife women,use of antihypertensive medications increased over time,with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers becoming the most commonly used antihypertensive medication,even for blacks. thiazide diuretic utilization increased over time for all race/ethnic groups as did use of calcium channel blockers among blacks; both patterns are in line with guideline recommendations for the management of hypertension. © 2017 the authors.