Abstract FR471: Trends in Hypertension Prevalence by Insurance Status, Education, and Income in U.S. Adults (2019–2023)

Introduction: Social determinants of health contribute to disparities in hypertension (HTN). We evaluated recent national trends in HTN prevalence by insurance coverage, educational attainment, and family income. Hypothesis: We hypothesized that HTN prevalence trends would vary across insurance, education and income strata over time. Methods: Serial cross-sectional analysis of U.S. adults (≥18 years) using 2019–2023 National Health Interview Survey (NHIS) data. Self-reported physician-diagnosed HTN was assessed by: Insurance status (Private, Medicaid, Other coverage, Uninsured), Education (<High school, High school/GED, Some college, College graduate), Income (<100%, 100–199%, ≥200% federal poverty level [FPL]). Linear regression with interaction terms was used to test temporal trends across strata. R version 4.4.2 Results: Among 60 stratified estimates: Insurance: Overall HTN prevalence declined (−0.61%/year, p = 0.07), but increased for Private (+0.85%/year, p = 0.07) and Other coverage (+0.86%/year, p = 0.07) groups. Baseline HTN was highest with Other coverage (32.8%) and lowest in Uninsured (12.6%). Education: Adults with lower than High school had the highest baseline HTN (42.4%, p=0.019) but a significant annual decline (−0.78%/year, p=0.020). Income: Highest baseline HTN in <100% FPL (30.4%) vs. ≥200% FPL (25.7%). Non-significant declines occurred in low-income groups. Conclusion: From 2019–2023, HTN prevalence improved among adults with lower education but worsened for privately and publicly insured groups. Inequities persist by income and insurance type, underscoring the need for targeted interventions addressing coverage continuity and social determinants.