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September 12, 2026The Journals of Gerontology Series A

Being overweight is linked to ~100% higher odds of uncontrolled hypertension among rural Medicare beneficiaries.

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Why the study?

Rural U.S. adults experience higher hypertension prevalence and CVD mortality than urban peers, prompting this study to estimate uncontrolled hypertension prevalence and associated factors among rural South Carolina Medicare beneficiaries.

Population

813 Medicare beneficiaries with diagnosed hypertension in Abbeville County, South Carolina

Comparison

Individual, behavioral, clinical, and contextual factors associated with uncontrolled hypertension

Design

Cross-sectional analysis of annual review data

Key result

Being overweight was associated with higher odds of uncontrolled hypertension compared to a healthy weight among rural Medicare beneficiaries (aOR 2.0; 95% CI 1.2-3.3; p=0.005).

Authors

SLStella T. LarteyDMDouglas Boylston MooreBWBrian Alex Witrick

Discussion

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Overview

Association suggests weight management focus in rural elderly hypertension; hypothesis-generating and should not yet change practice.

Key Points

  • To estimate the prevalence of uncontrolled hypertension and identify contributing individual, clinical, and behavioral factors among Medicare beneficiaries in rural South Carolina.
  • Analyzed health records from the annual review of Medicare beneficiaries diagnosed with hypertension (N = 813; 55.6% female; mean age 73.2 ± 8.48 years) in Abbeville County, South Carolina, between July 2024 and January 2025.
  • Defined uncontrolled hypertension as blood pressure ≥130/80 mmHg with or without antihypertensive medications.
  • Evaluated individual, behavioral, clinical, and contextual associations using generalized linear models with a binomial distribution and logit link.
  • The overall prevalence of uncontrolled hypertension was 76.3% (95% CI: 73.2, 79.1).
  • Compared to healthy weight, higher odds of uncontrolled hypertension were observed in overweight (aOR = 2.0; 95% CI: 1.2, 3.3; p = 0.005) and obese beneficiaries (aOR = 2.1; 95% CI: 1.1, 2.8; p = 0.010).
  • Reporting physical activity 'most of the time' was associated with higher odds of uncontrolled hypertension compared to no physical activity (aOR = 1.57; 95% CI: 1.05, 2.34; p = 0.027).

Study Design

Type

Cross-Sectional (n=813)

Multicenter

No

Structured PICO

P
Population
813 Medicare beneficiaries (mean age 73.2 years, 55.6% female) diagnosed with hypertension in rural South Carolina, evaluated between July 2024 and January 2025.
O
Outcome
Prevalence of uncontrolled hypertension (defined as blood pressure ≥130/80 mmHg with or without antihypertensive medications)surrogate

Main Result

Odds Ratio: 2 (95% CI 1.2–3.3)

p-value: p=0.005

There is a high burden of uncontrolled hypertension (76.3%) among Medicare beneficiaries in rural South Carolina, which is strongly associated with being overweight or obese.

Cite This Study

Lartey et al. (2026) conducted a cross-sectional in Hypertension (n=813). Overweight vs. Healthy weight was evaluated on Uncontrolled hypertension (blood pressure ≥130/80 mmHg) (aOR 2.0, 95% CI 1.2-3.3, p=0.005). Being overweight was associated with higher odds of uncontrolled hypertension compared to a healthy weight among rural Medicare beneficiaries (aOR 2.0; 95% CI 1.2-3.3; p=0.005).

synapsesocial.com/papers/6aa51ee4327956e4761f8e1dhttps://doi.org/10.1093/gerona/glag228
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