Abstract Details

Title Racial Disparities in Hypertension Management Among Multiple Sclerosis Patients

Topic Multiple Sclerosis

Presentation(s) S40 - MS Diversity and Epidemiology (3:54 PM-4:06 PM)

Poster/Presentation
Number 003

Background

Hypertension (HTN) is associated with a worsened disease course in multiple sclerosis (MS) patients. BAs are more likely to develop HTN than WAs.

Objective

To determine the odds of uncontrolled HTN in Black Americans (BAs) vs. White Americans (WAs) with MS and whether there are racial disparities in anti-hypertensive treatment.

Design/Methods

Multiple Sclerosis Partners Advancing Technology Health Solutions (MS PATHS) collects multi-institutional longitudinal data on MS patients. MS PATHS data were analyzed and patients with ≥2 blood pressure (BP) readings ≥140/90 were identified as having uncontrolled HTN. Logistic regression determined the odds of uncontrolled HTN in BAs versus WAs while adjusting for important covariates including age, disease duration, MS phenotype, insurance type, diabetes (DM), and hyperlipidemia (HLD). The adjusted odds of being on anti-hypertensive medications in BAs versus WAs with uncontrolled HTN and MS were determined. Factors associated with receiving anti-hypertensive treatment were analyzed.

Results

There were 10,673 patients with ≥2 BP measurements of whom 3,112 (28%) had uncontrolled HTN. The WA cohort was older (mean age 49.2 vs. 45.7 for BAs), but uncontrolled HTN was more prevalent in BAs (32.6%) as compared to WAs (28.3%). BAs had 31% increased odds of uncontrolled HTN than WAs (p<0.001). BAs with uncontrolled HTN had 68% (p<0.001) higher odds of being on an anti-hypertensive compared to WAs. Older age (OR=1.06, p<0.001), comorbid HLD (OR=3.93, p<0.001), and comorbid DM (OR=7.09, p<0.001) were associated with higher odds of BAs with uncontrolled HTN being on anti-hypertensive therapy. Similar relationships were seen among WA MS patients, but the effects of DM (OR=4.15, p<0.001) and HLD (OR=2.29, p<0.001) were less pronounced.

Conclusions

In this large MS cohort, BAs had significantly higher odds of uncontrolled HTN but were more likely to be on anti-hypertensive medications. This paradoxical finding requires further investigation. Future longitudinal studies will explore potential explanations.

Authors/Disclosures
Devon Conway, MD PRESENTER	Dr. Conway has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis Pharmaceuticals. Dr. Conway has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca. Dr. Conway has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Conway has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. The institution of Dr. Conway has received research support from Novartis. The institution of Dr. Conway has received research support from BMS. The institution of Dr. Conway has received research support from Biogen.
Farren Briggs, PhD (University of Miami Miller School of Medicine)	The institution of Prof. Briggs has received research support from NIH. The institution of Prof. Briggs has received research support from Michael J. Fox Foundation.
Ellen M. Mowry, MD, FAAN (Johns Hopkins University)	Dr. Mowry has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BeCareLink, LLC. The institution of Dr. Mowry has received research support from Biogen. The institution of Dr. Mowry has received research support from Genentech. Dr. Mowry has received publishing royalties from a publication relating to health care.
Kathryn Fitzgerald, PhD (Johns Hopkins University)	The institution of Dr. Fitzgerald has received research support from NIH. The institution of Dr. Fitzgerald has received research support from National MS Society.
Carrie M. Hersh, DO, MSc, FAAN (Cleveland Clinic Lou Ruvo Center for Brain Health)	Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech_GN41791. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol-Myers Squibb . Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon Therapeutics. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Genzyme. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. The institution of Dr. Hersh has received research support from Biogen. The institution of Dr. Hersh has received research support from Novartis. The institution of Dr. Hersh has received research support from Genentech_GN41791. The institution of Dr. Hersh has received research support from PCORI. The institution of Dr. Hersh has received research support from Bristol Myers Squibb.