Understanding differences in risk factors can assist in identifying means to reduce racial/ethnic disparities in type 2 diabetes (T2D) prevalence. Different types of blood pressure (BP) lowering drugs are associated with different levels of T2D risk. This study examined the utilization of BP-lowering drugs among US adults aged 18 and over without diabetes with diagnosed hypertension by racial/ethnic group. We used self-report or ICD-10 diagnostic codes to identify our study population using the 2016-2019 Medical Expenditure Panel Survey. The high T2D risk drugs included beta-blockers and diuretics and the low-risk drugs were ACEI and ARBs. We calculated the percentage of high-risk and low-risk drug use in non-Hispanic Black (NHB) , non-Hispanic White (NHW) , Hispanic, and Asian persons. Logistic regression was used to compare the uses of two drug types across different racial/ethnic groups, controlling for demographics, history of cardiovascular and renal diseases, insurance, duration of hypertension, and general health measurements. We have identified 18,283 individuals, with a mean age of 60.7 and 52.4% were females. Compared with NHB, NHW persons (adjusted odds ratio (aOR) :0.90, 95% CI: 0.58-0.98) , Hispanic (aOR:0.62, 95% CI: 0.56-0.70) , and Asian (aOR:0.54, 95% CI: 0.46-0.64) persons were less likely to receive high-risk drugs. Meanwhile, NHW (aOR: 1.19, 95% CI: 1.09-1.29) , Hispanic (aOR:1.14, 95% CI: 1.03-1.27) , and Asian (aOR:1.19, 95% CI: 1.02-1.40) persons were more likely to use low-risk drugs than NHB persons (all p<0.05) . The highest use of high-risk BP-lowering drugs and the lowest use of low-risk BP-lowering drugs by NHB persons could increase their risks of T2D and contribute to disparities in T2D prevalence between NHB and other racial/ethnic groups. Future studies can quantify the effect of the BP-lowering drug choices on T2D disparities.


H. Shao: Board Member; BRAVO4HEALTH, LLC. K. Alkhuzam: None. J. Guo: None. T. Jiao: None. S. M. Smith: None. P. Zhang: None. E. W. Gregg: None.

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