Hypertension Care Quality and Incidence of Complications Among Hypertensive Patients With Disabilities in Korea: An Analysis of a Cohort Study Using National Health Insurance Data

Background: Hypertension is more prevalent among individuals with disabilities than in the general population.This study analyzed long-term trends in disparities in hypertension care quality and the incidence of hypertensive complications among individuals with and without disabilities.Methods: This retrospective cohort study followed 52,743 hypertensive patients aged 20 or older with disabilities newly diagnosed in 2010, along with 47,564 age-and sex-matched patients without disabilities, from 2011 to 2019.Hypertension care quality was assessed using indicators of medication adherence and the completion of three complication-monitoring tests at recommended frequency: blood test, urine test, and electrocardiogram (ECG).Hypertensive complications included major cardiovascular and cerebrovascular events, kidney diseases, and all-cause mortality.Logistic regression was repeated annually to assess hypertension care quality, and Cox-proportional model was used to estimate the risk of hypertension-related complications.Results: Hypertensive patients with disabilities consistently demonstrated lower medication adherence throughout the study period (adjusted odds ratio [aOR], 0.90-0.96,depending on the year), but a higher likelihood of undergoing screenings at recommended frequency (e.g., aOR for blood test, 1.31-1.39,for urine test, 1. 24-1.33, and for ECG, 1.30-1.37).The risk of complications remained significantly higher among hypertensive patients with disabilities, even after adjusting for care quality indicators (e.g., adjusted hazard ratio for cardiovascular events: 1.36, 95% confidence interval: 1.31-1.41).Subgroup analyses revealed that the excess