Hypertension in ethnic populations: tailoring treatments

The Hispanic population in the United States comprises different and distinct cultures and genetic backgrounds. Most of the data on hypertension in this community are specific to Mexican Americans, in whom studies consistently show a lower prevalence of the disease compared with non-Hispanic whites and blacks. Mexican Americans have lower levels of awareness of hypertension, and fewer of them demonstrate adequate control of blood pressure compared with whites and blacks. Mexican Americans have a higher prevalence of cardiovascular risk factors other than hypertension, such as hypercholesterolemia, altered glucose metabolism, type 2 diabetes mellitus, and obesity (the metabolic syndrome), compared with whites and blacks. Hispanic Americans of Caribbean descent have a prevalence of hypertension similar to that in the black community. The reasons for the lack of awareness of hypertension in the Hispanic community and for the low rates of control with antihypertensive drugs are discussed.