Abstract TH975: Limited English Proficiency and its Association with Hypertension Cascade among a Nationally Representative Sample of Reproductive-aged Women

Abstract

Background: Hypertension is a major risk factor for cardiovascular disease among reproductive-aged women. Language barriers may contribute to disparities in hypertension awareness, diagnosis, and treatment. This study examines the association between limited English proficiency (LEP) and hypertension outcomes using nationally representative data. Hypothesis: Women of reproductive age with limited English proficiency have lower odds of hypertension awareness, prevalence, and treatment compared to English-proficient women. Methods: We analyzed a cross-sectional sample of women of reproductive age (18-50 years) using data from the National Health and Nutrition Examination Survey (2005-2023). LEP was defined as completing any portion of the interview in a language other than English or requiring an interpreter. Hypertension was defined as average systolic blood pressure (BP) ≥140 mmHg or diastolic BP ≥90 mmHg, or self-reported diagnosis. Outcomes included awareness (diagnosed; yes/no), prevalence (measured BP), and treatment (medication use; yes/no). Survey-weighted multivariable logistic regression models estimated the odds of hypertension outcomes and LEP adjusting for age, education, race/ethnicity, marital status, insurance, employment, and income. Results: Among 29,772,084 women of reproductive age, 3.9% had LEP. Hypertension was less prevalent among LEP vs. English-proficient women (10.1% vs. 15.9%), though not significant after adjustment (adjusted odds ratio [aOR] 0.55, 95% CI 0.26–1.17). Hypertension awareness (8.6% vs. 14.3%; aOR 0.41, 95% CI 0.14–1.18) and treatment (61.6% vs. 68.7%; aOR 0.27, 95% CI 0.02–4.55; p = 0.35) were also lower among LEP women vs. English-proficient women, respectively. Conclusion: Women of reproductive age with LEP exhibit lower hypertension prevalence despite lower awareness and treatment rates. This pattern suggests the presence of protective pathways such as cultural health practices or differing health behaviors, that warrant further investigation. Advancing linguistically inclusive public health strategies and examining these potential protective factors are essential to improve cardiovascular equity.