(P23-081-23) Assessing the Effect of Area-based Socioeconomic Status on Hypertension in Patients With Diabetes Mellitus

Objectives: The co-existence of diabetes mellitus and hypertension presents a substantial challenge for the aging population and our healthcare system. In particular, those with type 2 diabetes mellitus were at 2-4 times the risk of developing hypertension. However, it is not well understood how socioeconomic status (SES) can affect this relationship. The objective of this study is to study the effect of an area-based SES indicator on hypertension in adults with diabetes mellitus.

Methods: Hospital discharge data from the National Inpatient Sample (NIS) from 2012-2017 was used. All non-pregnant adults (18+) were included for analysis. Diagnosis of diabetes mellitus and hypertension were based on the International Classification of Diseases (ICD) 9th (ICD-9) and 10th (ICD-10) Revisions of medical diagnosis codes. The median household income for zip code quartile (MHIZCQ) is an indicator for the area-based SES. We created a logistic model to calculate the odds of having hypertension with different types of diabetes mellitus then assessed the effects of MHIZCQ on the odds ratios. We then created a multivariate logistic model controlling for sociodemographic variables (age, sex, race, payer status, urbanicity) as well as health variables (obesity, depression, cigarette smoking, alcohol intake).

Results: A total of 30,682,292 observations were used for analysis. 70.59% of the sample did not have diabetes mellitus. 1.26% had type 1 diabetes, 27.78% had type 2 diabetes, and 0.34% had another type of diabetes. 61.24% of the sample had hypertension. Our findings found that those with diabetes had a significantly higher odds of having hypertension compared to those without diabetes (type 1 OR: 1.147; type 2 OR: 4.274; other type OR: 1.346). After adjusting for MHIZCQ, the odds ratios were not significantly affected (defined as >10%) (type 1 OR: 1.136; type 2 OR: 4.244; other type OR: 1.336). The odds ratios were mostly affected by age and obesity (type 1 OR: 2.780; type 2 OR: 3.289; other type OR: 1.733).

Conclusions: The findings suggest that higher SES in individuals with diabetes may help mitigate the development of hypertension. Targeted policy measures should focus on improving SES of this vulnerable population. Further research is warranted to understand the relationship between diabetes and hypertension.

Funding Sources: None