Compared with metropolitan areas, micropolitan residence was associated with lower odds of hypertension (OR 0.85), and isolated rural residents had lower odds of uncontrolled hypertension (OR 0.82).
Cohort (n=363,539)
Yes
Does hypertension prevalence and control vary across the rural–urban continuum?
Hypertension prevalence and uncontrolled hypertension were found to be lower in non-metropolitan areas compared to metropolitan areas in Northeast Texas, with persistent racial disparities across all geographic settings.
Odds Ratio: 0.85
Background: Rural US populations bear a high burden of cardiovascular disease, with hypertension contributing to the rural–urban gap. We examined hypertension prevalence and control across the rural–urban continuum among patients in a large healthcare system in Northeast Texas. Methods: We analyzed the electronic health record data from 363,539 patients with at least one outpatient encounter between September 2021 and April 2025. We defined hypertension using ICD-10-CM codes, antihypertensive prescriptions, or a blood pressure ≥ 130/80 mm Hg. We classified rurality using the Rural–Urban Commuting Area categories. Multivariable logistic regression models were adjusted for age, sex, race, ethnicity, insurance, and level of engagement with the healthcare system. Results: Compared with metropolitan areas, micropolitan residents had lower odds of hypertension (OR = 0.85). We found uncontrolled hypertension also to be more common in metropolitan areas, with a lower prevalence observed across non-metropolitan categories, particularly among isolated rural residents (OR = 0.82). Black patients exhibited higher rates of uncontrolled hypertension across all rural–urban categories. Continuity of care was associated with hypertension prevalence but not control. Conclusions: Hypertension prevalence and control vary across the rural–urban continuum in Northeast Texas, with consistent differences observed between metropolitan and some non-metropolitan residents. Persistent racial differences across all geographic settings support the need for targeted prevention and management strategies.
Tiruneh et al. (Sat,) conducted a cohort in Hypertension (n=363,539). Micropolitan residence vs. Metropolitan areas was evaluated on Hypertension prevalence (OR 0.85). Compared with metropolitan areas, micropolitan residence was associated with lower odds of hypertension (OR 0.85), and isolated rural residents had lower odds of uncontrolled hypertension (OR 0.82).