Comorbid hypertension and diabetes among U.S. women of reproductive age: Prevalence and disparities

J Diabetes Complications. 2018 Dec;32(12):1148-1152. doi: 10.1016/j.jdiacomp.2018.09.014. Epub 2018 Sep 26.


Aims: Diabetes is associated with significant pregnancy complications, which can be further exacerbated by comorbid hypertension. Racial/ethnic differentials in the burden of comorbid hypertension and diabetes among women of reproductive age have not been described.

Methods: Using Wave IV of the nationally representative National Longitudinal Study of Adolescent to Adult Health (Add Health), we analyzed survey and biological data from 6576 non-pregnant women who were aged 24-32 in 2007-2008. Hypertension and diabetes were identified by self-report of diagnosis and biological measurements taken during in-home interviews. We used logistic regression models to predict the presence of comorbid hypertension and diabetes and whether each was diagnosed.

Results: Over a third (36.0%) of women with diabetes had comorbid hypertension. Compared to non-Hispanic white women, more non-Hispanic black women had comorbid hypertension and diabetes (adjusted odds ratio (aOR) 5.93, 95% CI 3.84-9.16), and, if comorbid, were less likely to have a diabetes diagnosis (aOR 0.03, 95% CI 0.007-0.1) or hypertension diagnosis (aOR 0.22, 95% CI 0.08-0.65).

Conclusion: Comorbid hypertension and diabetes are more common among non-Hispanic black women and less likely to be diagnosed, signaling disparities threatening maternal and child health among women with diabetes.

Keywords: Comorbidity; Complications; Diabetes; Hypertension; Preconception care; Women's health.

MeSH terms

  • Adult
  • Age Factors
  • Comorbidity
  • Diabetes Complications / epidemiology
  • Diabetes Mellitus / epidemiology*
  • Female
  • Health Status Disparities*
  • Humans
  • Hypertension / complications
  • Hypertension / epidemiology*
  • Longitudinal Studies
  • Maternal Age
  • Preconception Care / statistics & numerical data
  • Pregnancy
  • Pregnancy Complications / epidemiology
  • Pregnancy Complications / prevention & control
  • Pregnancy in Diabetics / epidemiology
  • Pregnancy in Diabetics / prevention & control
  • Prevalence
  • Reproduction* / physiology
  • Socioeconomic Factors
  • United States / epidemiology
  • Young Adult