Abstract 4146960: Social Determinants of Health Associated With Worse Hypertension Stage in Low-Middle Income Country

Background: Hypertension (HTN) is a major risk factor for cardiovascular disease (CVD) and is the leading cause of morbidity and mortality globally, with a rise in prevalence in low and middle-income countries (LMIC). While HTN awareness, treatment, and control have increased in high-income countries (HIC), this increase is less marked in LMIC. Objective: To describe the characteristics of social determinants of health associated with HTN in LMIC rural areas. Methods: Data was obtained from a cluster-randomized trial in Guatemala, implemented in rural areas nationwide. Trained interviewers used standardized questionnaires and measurements to collect data. HTN stage was defined according to AHA’s 2018 guidelines. The chi-squared test compared sociodemographic characteristics between HTN stages I and II. Results: Data from 1580 hypertensive participants with blood pressure readings over 130/80 mmHg with or without anti-hypertensive treatment was analyzed. The median age was 63 years, with 72% women. Spanish (Guatemala’s official language) was spoken by 65%, and the illiteracy rate was 58%. Mayan ethnicity represented 43%. The proportion of people aware of their HTN diagnosis was 69%, but only 60% of them were on anti-hypertensives. Median systolic and diastolic blood pressure (BP) was 142.5 and 76.5 mmHg, respectively. Median BMI was 27.6 kg/m 2 . A statistically significant difference (p<0.05) was observed between HTN stages I and II in ethnicity (37% vs. 46% belonged to the Mayan Indigenous group), median age (61 vs. 64 years), Spanish language fluency (68% vs. 64%); literacy (46.3% vs. 39.6%); known HTN (74% vs. 66%); established anti-HTN treatment (69% vs. 54%); treatment adherence (76% vs 68%); and body mass index (28.1 vs 27.4 kg/m2). Conclusions: These results highlight significant disparities in the characteristics and management of hypertension among rural populations of LMIC. They emphasize the need for targeted interventions to improve hypertension control, specifically in rural areas, like enhancing access to healthcare, improving literacy and language proficiency, and addressing the specific needs of the Mayan indigenous population due to differing cultural habits and beliefs.