Idiopathic Intracranial Hypertension Disproportionately Affects Black Women

A study published in Neurology, showed that Black women were twice as likely to have idiopathic intracranial hypertension (IIH), regardless of body mass index (BMI) or obesity. IIH was more common among women who live in low-income areas or in areas with more fast-food restaurants and convenience stores than grocery stores. After adjusting for for those factors as well as age, but not BMI, women with IIH were more than 3 times as likely to be Black and twice as likely to be Hispanic. Although Hispanic women were also more likely to have IIH than white women, this correlation was no longer significant after controlling for BMI. Only 5% of the participants with IIH and 3% of the control group without IIH were Hispanic, however, suggesting this result should be interpreted with caution. As noted by the study authors, these results show that income, BMI, and access to food resources factor into, but do not completely account for the disparity in who is affected by IIH. 

“We found that women with idiopathic intracranial hypertension were more than twice as likely to be Black than people who did not have the condition, even after we adjusted for their body mass index, so we believe that racial differences are not explained solely by obesity,” said study author Venkatesh Brahma, MD, of the University of Pennsylvania in Philadelphia. “Our results provide some support for racial disparities that can be seen in this condition. Though at least some of this relationship is driven by the link between obesity and idiopathic intracranial hypertension with low-income neighborhoods and food swamps, it does not fully explain the differences, and other systemic health disparities are likely involved.” 
 
“Additional studies are needed to help us understand the link between race, ethnicity, access to healthy foods, exposure to unhealthy foods, other social determinants of health, and idiopathic intracranial hypertension,” Brahma said. “Our findings suggest that multiple factors are likely involved.”

Among the participants with IIH 47% were Black, 5% were Hispanic, and 48% were white. The participants without IIH were 20% Black, 3% Hispanic, and 77% white. The study enrolled 223 women who were seen by a neuro-ophthalmologist at the university over 8 years who had intracranial hypertension and 4,783 who did not. Participants had their health records reviewed and then used their addresses to determine neighborhood income and access to grocery stores.