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Hypertension Prevalence, Treatment, and Related Behaviors Among Asian Americans: An Examination by Method of Measurement and Disaggregated Subgroups

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Abstract

Background

Data on hypertension among Asian Americans is lacking and often aggregated, which can mask important ethnic differences. This study aims to provide a comprehensive view of hypertension and hypertension-related behaviors, including hypertension treatment, management, and information seeking, among Chinese, Korean, and Vietnamese Americans.

Methods

Data were collected from 600 foreign-born Asian Americans (201 Chinese, 198 Korean, and 201 Vietnamese participants) in the Washington–Baltimore metropolitan area, aged 18 years and over, from 2013 to 2014. Hypertension was assessed using direct measurement and self-report of having ever been told by a physician. Hypertension prevalence was compared based on the method of assessment, ethnicity, and sex.

Results

The age-adjusted hypertension prevalence from direct measurement was 27.5%, which is higher than the 2011–2014 National Health and Nutrition Examination Survey estimate for Asians (24.9%). Hypertension prevalences from self-report among Chinese, Korean, and Vietnamese were 13.4%, 23.2%, and 22.9%, respectively, which are lower than 2014 California Health Interview Survey estimates (15.6%, 18.4%, and 25.8%) with the exception of Korean participants. In regard to hypertension-related behaviors, 67.8% of hypertensive adults received management, 64.3% took antihypertensive medication, and 67.0% sought information to improve their hypertension.

Conclusions

Disaggregated data on hypertension based on measured blood pressure may prevent underestimation from self-report, particularly among those with limited healthcare access. More accurate and objective assessment of hypertension is needed for improved monitoring of hypertension among Asian-American subgroups.

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References

  1. Hoeffel EM, Rastogi S, Kim MO, Hasan S. The Asian population: 2010. In: 2010 U.S. Census Briefs. U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau. 2012. https://www.census.gov/prod/cen2010/briefs/c2010br-11.pdf. Accessed December 14 2017.

  2. Palaniappan LP, Araneta MRG, Assimes TL, Barrett-Connor EL, Carnethon MR, Criqui MH, et al. Call to action: cardiovascular disease in Asian Americans a science advisory from the American Heart Association. Circulation. 2010;122(12):1242–52.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics—2016 update: a report from the American Heart Association. Circulation. 2016;133(4):e38–e360.

    PubMed  Google Scholar 

  4. Yoon SS, Fryar CD, Carroll MD. Hypertension prevalence and control among adults: United States, 2011-2014. NCHS Data Brief. 2015;(220):1–8.

  5. Hastings KG, Jose PO, Kapphahn KI, Frank AT, Goldstein BA, Thompson CA, et al. Leading causes of death among Asian American subgroups (2003–2011). PLoS One. 2015;10(4):e0124341.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289(19):2560–71.

    Article  CAS  PubMed  Google Scholar 

  7. Pimenta E, Oparil S. Prehypertension: epidemiology, consequences and treatment. Nat Rev Nephrol. 2010;6(1):21–30.

    Article  PubMed  Google Scholar 

  8. Wang Y, Wang QJ. The prevalence of prehypertension and hypertension among US adults according to the new joint national committee guidelines: new challenges of the old problem. Arch Intern Med. 2004;164(19):2126–34.

    Article  PubMed  Google Scholar 

  9. Zhao B, Jose PO, Pu J, Chung S, Ancheta IB, Fortmann SP, et al. Racial/ethnic differences in hypertension prevalence, treatment, and control for outpatients in northern California 2010–2012. Am J Hypertens. 2015;28(5):631–9.

    Article  CAS  PubMed  Google Scholar 

  10. Kramer H, Han C, Post W, Goff D, Diez-Roux A, Cooper R, et al. Racial/ethnic differences in hypertension and hypertension treatment and control in the multi-ethnic study of atherosclerosis (MESA). Am J Hypertens. 2004;17(10):963–70.

    Article  PubMed  Google Scholar 

  11. Lau DS, Lee G, Wong CC, Fung GL, Cooper BA, Mason DT. Characterization of systemic hypertension in the San Francisco Chinese community. Am J Cardiol. 2005;96(4):570–3.

    Article  PubMed  Google Scholar 

  12. Kim MT, Kim KB, Juon HS, Hill MN. Prevalence and factors associated with high blood pressure in Korean Americans. Ethn Dis. 2000;10(3):364–74.

    CAS  PubMed  Google Scholar 

  13. Kim MT, Juon HS, Hill MN, Post W, Kim KB. Cardiovascular disease risk factors in Korean American elderly. West J Nurs Res. 2001;23(3):269–82.

    Article  CAS  PubMed  Google Scholar 

  14. Duong DA, Bohannon AS, Ross MC. A descriptive study of hypertension in Vietnamese Americans. J Community Health Nurs. 2001;18(1):1–11.

    Article  CAS  PubMed  Google Scholar 

  15. Watson RE, Karnchanasorn R, Gossain VV. Hypertension in Asian/Pacific Island Americans. J Clin Hypertens. 2009;11(3):148–52.

    Article  Google Scholar 

  16. Smith SC, Clark LT, Cooper RS, Daniels SR, Kumanyika SK, Ofili E, et al. Discovering the full spectrum of cardiovascular disease minority health summit 2003: report of the obesity, metabolic syndrome, and hypertension writing group. Circulation. 2005;111(10):e134–e9.

    PubMed  Google Scholar 

  17. Nwankwo T, Yoon SS, Burt V, Gu Q. Hypertension among adults in the United States: National Health and Nutrition Examination Survey, 2011-2012. NCHS Data Brief. 2013;(133):1-8.

  18. Barnes PM, Adams PF, Powell-Griner E. Health characteristics of the Asian adult population: United States, 2004-2006. Adv Data. 2008;(394):1-22

  19. Han H-R, Kim KB, Kang J, Jeong S, Kim E-Y, Kim MT. Knowledge, beliefs, and behaviors about hypertension control among middle-aged Korean Americans with hypertension. J Community Health. 2007;32(5):324–42.

  20. Devers K, Gray B, Ramos C, Shah A, Blavin F, Waidmann T. The feasibility of using electronic health records (EHRs) and other electronic health data for research on small populations. The Urban Institute Health Policy Center, Washington, DC. 2013. https://aspe.hhs.gov/report/feasibility-using-electronic-health-data-research-small-populations. Accessed December 14 2016.

  21. Jose P, Zhao B, Baek M, Chung S, Fortmann S, Palaniappan L. Variation in hypertension prevalence among Asian American subgroups: results from PACS (Pan Asian Cohort Study). Clin Med Res. 2013;11(3):136.

    Article  PubMed Central  Google Scholar 

  22. Centers for Disease Control and Prevention/National Center for Health Statistics. 2015 National Health Interview Survey Questionnaire—Sample Adult. Hyattsville, Maryland: U.S. Department of Health and Human Services; 2016. ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Survey_Questionnaires/NHIS/2015/english/qadult.pdf. Accessed 12 December 2018.

  23. Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System 2015 codebook report land-line and cell-phone data. Atlanta, Georgia: U.S. Department of Health and Human Services; 2016. https://www.cdc.gov/brfss/annual_data/2017/pdf/codebook17_llcp-v2-508.pdf. Accessed 12 December 2018.

  24. National Center for Chronic Disease Prevention and Health Promotion. Division of Population Health. BRFSS frequently asked questions (FAQs). U.S. Department of Health & Human Services, Atlanta, GA; 2015. http://www.cdc.gov/brfss/about/brfss_faq.htm. Accessed December 14 2017.

  25. California Health Interview Survey. CHIS 2014 adult survey public use file. [computer file]. Los Angeles, CA: UCLA Center for Health Policy Research; July 2017. http://healthpolicy.ucla.edu/chis/data/Pages/public-use-data.aspx. Accessed 12 December 2018.

  26. UCLA Center for Health Policy Research. CHIS methods to accurately represent California’s diverse population. In: CHIS Data Quality. 2012. http://healthpolicy.ucla.edu/chis/design/Pages/data-quality7.aspx. Accessed August 26 2016.

  27. Centers for Disease Control and Prevention/National Center for Health Statistics. NHANES 2011–2012 questionnaire data overview: questionnaire and interview languages. U.S. Department of Health & Human Services, Atlanta, GA. 2014. https://wwwn.cdc.gov/nchs/nhanes/ContinuousNhanes/OverviewQuex.aspx?BeginYear=2011. Accessed 12 December 2018.

  28. Juon H-S, Strong C, Kim F, Park E, Lee S. Lay health worker intervention improved compliance with hepatitis B vaccination in Asian Americans: randomized controlled trial. PLoS One. 2016;11(9):e0162683.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Daskalopoulou SS, Rabi DM, Zarnke KB, Dasgupta K, Nerenberg K, Cloutier L, et al. The 2015 Canadian hypertension education program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Can J Cardiol. 2015;31(5):549–68.

    Article  PubMed  Google Scholar 

  30. Eguchi K, Kuruvilla S, Ishikawa J, Ogedegbe G, Gerin W, Schwartz JE, et al. Correlations between different measures of clinic, home, and ambulatory blood pressure in hypertensive patients. Blood Press Monit. 2011;16(3):142–8.

    Article  PubMed  Google Scholar 

  31. National Heart Lung, and Blood Institute. What is hypotension? National Institutes of Health, Bethesda, MD. 2010. https://www.nhlbi.nih.gov/health/health-topics/topics/hyp. Accessed July 15 2017.

  32. Ye J, Rust G, Baltrus P, Daniels E. Cardiovascular risk factors among Asian Americans: results from a National Health Survey. Ann Epidemiol. 2009;19(10):718–23.

    Article  PubMed  Google Scholar 

  33. Reckelhoff JF. Gender differences in the regulation of blood pressure. Hypertension. 2001;37(5):1199–208.

    Article  CAS  PubMed  Google Scholar 

  34. Fang J, Yang Q, Ayala C, Loustalot F. Disparities in access to care among US adults with self-reported hypertension. Am J Hypertens. 2014;27(11):1377–86.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Tran H, Do V, Baccaglini L. Health care access, utilization, and management in adult Chinese, Koreans, and Vietnamese with cardiovascular disease and hypertension. J Racial Ethn Health Disparities. 2016;3(2):340–8.

    Article  PubMed  Google Scholar 

  36. Lee J-E, Han H-R, Song H, Kim J, Kim KB, Ryu JP, et al. Correlates of self-care behaviors for managing hypertension among Korean Americans: a questionnaire survey. Int J Nurs Stud. 2010;47(4):411–7.

    Article  PubMed  Google Scholar 

  37. Pham TM, Rosenthal MP, Diamond JJ. Hypertension, cardiovascular disease, and health care dilemmas in the Philadelphia Vietnamese community. Fam Med. 1999;31:647–51.

    CAS  PubMed  Google Scholar 

  38. Vawter L, Tong X, Gemilyan M, Yoon PW. Barriers to antihypertensive medication adherence among adults—United States, 2005. J Clin Hypertens. 2008;10(12):922–9.

    Article  Google Scholar 

  39. Ferdinand KC. Hypertension in minority populations. J Clin Hypertens. 2006;8(5):365–8.

    Article  Google Scholar 

  40. de Souza RJ, Anand SS. Cardiovascular disease in Asian Americans: unmasking heterogeneity. J Am Coll Cardiol. 2014;64(23):2495–7.

    Article  PubMed  Google Scholar 

  41. Ma GX, Lee M, Bhimla A, Tan Y, Gadegbeku CA, Yeh MC et al. Risk assessment and prevention of hypertension in Filipino Americans. J Community Health. 2017;42(4):797-805.

  42. Clough J, Lee S, Chae DH. Barriers to health care among Asian immigrants in the United States: a traditional review. J Health Care Poor Underserved. 2013;24(1):384–403.

    Article  PubMed  Google Scholar 

  43. Vargas CM, Burt VL, Gillum RF, Pamuk ER. Validity of self-reported hypertension in the National Health and nutrition examination survey III, 1988–1991. Prev Med. 1997;26(5):678–85.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This study was supported by the National Cancer Institute (R01CA163805)..

Funding

This study was supported by the National Cancer Institute (R01CA163805).

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, 4200 Valley Drive, College Park, MD, 20742, USA

    Mary Y. Jung, Sunmin Lee & Stephen B. Thomas

  2. Department of Medical Oncology, Division of Population Science, Thomas Jefferson University, 834 Chestnut St, Philadelphia, PA, USA

    Hee-Soon Juon

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  1. Mary Y. Jung
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Correspondence to Mary Y. Jung.

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All procedures performed involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants in the study.

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Jung, M.Y., Lee, S., Thomas, S.B. et al. Hypertension Prevalence, Treatment, and Related Behaviors Among Asian Americans: An Examination by Method of Measurement and Disaggregated Subgroups. J. Racial and Ethnic Health Disparities 6, 584–593 (2019). https://doi.org/10.1007/s40615-018-00557-6

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  • DOI: https://doi.org/10.1007/s40615-018-00557-6

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