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Undertreatment of hypertension in older Mexican Americans
S Satish1, C A Stroup-Benham, D V Espino
1Department of Internal Medicine, The University of Texas Medical Branch, Galveston 77555-0460, USA.
Objective:
To identify the prevalence of hypertension and factors associated with nontreatment and poor control of hypertension in Mexican Americans aged 65 years and older.
Design:
A population-based survey of older Mexican Americans conducted in 1993-1994.
Setting:
Subjects residing in five Southwestern states: Texas, New Mexico, Colorado, Arizona, and California.
Participants:
An area probability sample of 3050 noninstitutionalized Mexican American men and women aged 65 and older took part in a 90-minute in-home interview, which included review of all medications taken and two sitting blood pressure measurements.
Outcome Measures:
Measured were previous diagnoses of hypertension, current medication for hypertension, and current blood pressure
Results:
Sixty-one percent of older Mexican-Americans were hypertensive, and 51% of those with hypertension were taking antihypertensive medications. Only 25% of hypertensive subjects (18% of males and 30% of females) were in good blood pressure control (i.e., systolic blood pressure < 140 mm Hg and diastolic blood pressure < 90 mm Hg). In multivariate analyses, factors associated with increased likelihood of treatment included female gender (OR = 1.9), history of heart disease (OR = 2.4), possessing a regular source of health care (OR = 2.7), and having seen a physician two or more times in the previous year (OR = 3.8). These were also independent predictors of good blood pressure control.
Conclusion:
Nontreatment of hypertension is still a major public health concern in older Mexican Americans. We estimate that adequate blood pressure control in this population would prevent approximately 30,000 adverse cardiovascular events over 10 years, affecting approximately 6% of the entire Mexican American older population.