Ethnic disparities in treatment rates for hypertension and dyslipidemia: An analysis by different treatment indications: The Healthy Life in an Urban Setting study

Background: Studies have reported ethnic disparities in treatment rates for cardiovascular risk factors. These studies are generally based on treatment indications defined by individual cardiovascular risk factors (ICRF). However, according to most European guidelines, preventive treatment for these risk factors is recommended only among those with sufficient overall cardiovascular risk (OCR). Objective: To determine ethnic disparities in treatment rates for hypertension and dyslipidemia among those with an indication for treatment based on ICRF and OCR. Methods: Using data of the HELIUS study, we determined the occurrence of cardiovascular risk factors and treatment rates among 11357 participants from six ethnic backgrounds living in Amsterdam. Via logistic regression analyses, we determined ethnic differences in blood pressure (BP)-lowering or lipid-lowering treatment rates among those needing treatment based on ICRF (BP >140mmHg and LDL >2.5mmol/l, respectively) and on OCR (estimated overall 10-year cardiovascular disease risk according to SCORE). Results: Relative to the Dutch, ethnic minority men showed higher treatment rates for hypertension and dyslipidemia, regardless of whether OCR of ICRF recommendations for treatment were used. Ethnic minority women showed similar treatment rates relative to the Dutch based on OCR, but higher treatment rates based on ICRF recommendations (e.g. odds ratios for antihypertensive treatment ranged from 0.93 to 1.75 and from 1.26 to 1.93, respectively). Conclusion: Treatment rates for hypertension and dyslipidemia are not lower among ethnic minority groups relative to the Dutch. In some cases, they are even higher, but these differences may be overestimated whenever using ICRF as treatment indication.