Association of medical discrimination and hypertension in adults in the All of Us Research Program

Abstract Objectives To examine the associations of medical discrimination with hypertension (HTN) outcomes. Materials and Methods Using cross-sectional data from the All of Us Research Program (2018-2022), we defined elevated blood pressure (BP) as systolic BP ≥130 or diastolic BP ≥ 80 mm Hg. We defined HTN diagnosis as either (1) self-reported HTN or (2) a HTN billing code. Among participants with HTN, we assessed antihypertensive medication use and HTN control. Logistic regression models estimated the associations of medical discrimination (using the Discrimination in Medical Settings Scale) with each BP outcome. The full sample included 29 805 adults, of whom 10 359 adults had elevated BP. Results Medical discrimination was associated with higher odds of elevated BP (adjusted odds ratio [AOR] 1.05, 95% confidence interval [CI], 1.02-1.08) and HTN diagnosis (AOR 1.06, 95% CI, 1.02-1.10). Among participants with HTN, medical discrimination was not associated with treatment or control. Discussion Findings suggest that medical discrimination contributes to increased prevalence of elevated BP and HTN diagnosis. Conclusion Researchers should examine mechanisms linking medical discrimination with HTN.