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Predictors of Hypertension Awareness, Treatment, and Control Among Mexican American Women and Men

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Abstract

BACKGROUND

The burden of hypertension and related health care needs among Mexican Americans will likely increase substantially in the near future.

OBJECTIVES

In a nationally representative sample of U.S. Mexican American adults we examined: 1) the full range of blood pressure categories, from normal to severe; 2) predictors of hypertension awareness, treatment and control and; 3) prevalence of comorbidities among those with hypertension.

DESIGN

Cross-sectional analysis of pooled data from the National Health and Nutrition Examination Surveys (NHANES), 1999–2004.

PARTICIPANTS

The group of participants encompassed 1,359 Mexican American women and 1,421 Mexican American men, aged 25–84 years, who underwent a standardized physical examination.

MEASUREMENTS

Physiologic measures of blood pressure, body mass index, and diabetes. Questionnaire assessment of blood pressure awareness and treatment.

RESULTS

Prevalence of Stage 1 hypertension was low and similar between women and men (∼10%). Among hypertensives, awareness and treatment were suboptimal, particularly among younger adults (65% unaware, 71% untreated) and those without health insurance (51% unaware, 62% untreated). Among treated hypertensives, control was suboptimal for 56%; of these, 23% had stage ≥2 hypertension. Clustering of CVD risk factors was common; among hypertensive adults, 51% of women and 55% of men were also overweight or obese; 24% of women and 23% of men had all three chronic conditions-hypertension, overweight/obesity and diabetes.

CONCLUSION

Management of hypertension in Mexican American adults fails at multiple critical points along an optimal treatment pathway. Tailored strategies to improve hypertension awareness, treatment and control rates must be a public health priority.

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Acknowledgments

The authors thank Dr. David Ahn for his statistical and analytical expertise and Alana Koehler for her technical assistance in preparing the tables and figures. This research was supported by Public Health Service Training Grants T32 HL 07034 (AB) and K24 HL 086703 (RSS), both from the National Heart, Lung, and Blood Institute. This project was also supported by the Network for Multicultural Research on Health and Healthcare, Dept. of Family Medicine - UCLA David Geffen School of Medicine, funded by the Robert Wood Johnson Foundation.

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Authors and Affiliations

  1. Stanford Prevention Research Center, Stanford University, Stanford, CA, USA

    Andrea Bersamin PhD, Randall S. Stafford MD, PhD & Marilyn A. Winkleby PhD

  2. Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks, PO BOX 757000, Fairbanks, AK, 99775, USA

    Andrea Bersamin PhD

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  1. Andrea Bersamin PhD
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  2. Randall S. Stafford MD, PhD
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  3. Marilyn A. Winkleby PhD
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Correspondence to Andrea Bersamin PhD.

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Bersamin, A., Stafford, R.S. & Winkleby, M.A. Predictors of Hypertension Awareness, Treatment, and Control Among Mexican American Women and Men. J GEN INTERN MED 24 (Suppl 3), 521–527 (2009). https://doi.org/10.1007/s11606-009-1094-6

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  • DOI: https://doi.org/10.1007/s11606-009-1094-6

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