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Undiagnosed and Uncontrolled Hypertension and Hyperlipidemia among Immigrants in the US

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Abstract

Cardiovascular disease is a major cause of mortality and disability. We analyzed the National Health and Nutrition Examination Survey (1998–2008). We used logistic regression analysis to compare the odds of having undiagnosed and uncontrolled hypertension and hyperlipidemia among FB and US born adults sequentially adjusting for (1) age and gender, (2) income and education, and (3) insurance status. Among FB individuals, we identified factors independently associated with having each outcome using logistic regression analyses. Of 27,596 US adults, 22.6 % were foreign-born. In age- and -gender adjusted analyses, FB were more likely to have undiagnosed hypertension (OR 1.35, 95 % CI 1.13–1.63, p < 0.001), uncontrolled hypertension (OR 1.37, 95 % CI 1.15–1.64, p < 0.001), and uncontrolled hyperlipidemia (OR 1.35, 95 % CI 1.11–1.63, p = 0.002), while undiagnosed hyperlipidemia approached significance (OR 1.24, 95 % CI 0.99–1.56, p = 0.057). Having insurance was associated with a 5–15 % decrease in FB-US born disparities. Immigrants are at increased risk of undiagnosed and uncontrolled hypertension and hyperlipidemia.

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Acknowledgments

All authors report no conflicts of interest. All authors contributed substantially to the design of the study as well as to manuscript revision. Dr Zallman was responsible for writing the manuscript. Drs Zallman and McCormick were responsible for data analysis. Dr Zallman’s work was supported by an Institutional National Research Service Award #T32HP12706 from the Health Services and Resources Administration to support the Harvard Medical School Fellowship in General Medicine and Primary Care. Dr. Ayanian was supported by the Health Disparities Research Program of Harvard Catalyst | The Harvard Clinical and Translational Science Center (NIH Grant #1 UL1 RR 025758 and financial contributions from participating institutions). The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University and its affiliated academic health care centers, the National Center for Research Resources, or the National Institutes of Health. This study was presented at the Annual Meeting of the Society of General Internal Medicine in Phoenix, Arizona (May 2011) and the New England Regional Society of General Internal Medicine in Boston, MA (March 2011).

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Authors and Affiliations

  1. Department of Medicine, Cambridge Health Alliance, and Harvard Medical School, 1493 Cambridge Street, Macht 4th Floor, Cambridge, MA, 02139, USA

    Leah Zallman, David H. Himmelstein, Steffie Woolhandler, David H. Bor & Danny McCormick

  2. City University of New York School of Public Health, New York City, NY, USA

    David H. Himmelstein & Steffie Woolhandler

  3. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA

    John Z. Ayanian

  4. Division of General Medicine and Primary Care, Brigham and Women’s Hospital, Boston, MA, USA

    John Z. Ayanian

  5. University of Washington School of Medicine, Boise, ID, USA

    Andrew P. Wilper

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  1. Leah Zallman
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  2. David H. Himmelstein
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  3. Steffie Woolhandler
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  4. David H. Bor
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  5. John Z. Ayanian
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  7. Danny McCormick
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Correspondence to Leah Zallman.

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Zallman, L., Himmelstein, D.H., Woolhandler, S. et al. Undiagnosed and Uncontrolled Hypertension and Hyperlipidemia among Immigrants in the US. J Immigrant Minority Health 15, 858–865 (2013). https://doi.org/10.1007/s10903-012-9695-2

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