Prevalence, Awareness, Treatment, and Predictors of Control of Hypertension in New York City

Abstract

Background-Hypertension-related risk in urban areas may vary from national estimates; however, objective data on prevalence and treatment in local areas are scarce. We assessed hypertension prevalence, awareness, treatment, and control among New York City (NYC) adults. Methods and Results-The NYC Health And Nutrition Examination Survey (HANES), modeled on the national HANES, was conducted in 2004 with a representative sample of noninstitutionalized NYC residents Ն20 years of age. Hypertension outcomes were examined with interview and examination data (nϭ1975). Multiple logistic regression was used to assess factors associated with control among adults with hypertension. We found that 25.6% of NYC adults had hypertension.

Awareness, Treatment and Control of Hypertension Among Filipino Immigrants

“…One previous study in NYC examined these outcomes and included an Asian group, but all Asian subgroups were aggregated due to small sample size. 29 Poor control among individuals on medication for hypertension is of particular concern; while 78 % of aware individuals were taking medication for hypertension, the rate of control (38.4 %) was lower than the rate previously seen among African Americans, Mexican Americans, and whites. [26][27][28] A qualitative study examining 27 uninsured hypertensive Filipino immigrants found that forgetfulness, time constraints, ethnic/cultural practices, stress, and medication side effects contributed to nonadherence and uncontrolled hypertension.…”

“…19 The rate of hypertension awareness (72.1 %) among Filipino Americans in this study was lower than the unadjusted rate for NYC overall (83.0 %), as well as other minority populations in NYC, including non-Hispanic Blacks (85.5 %), Hispanics (81.9 %), and Asians overall (78.3 %). 29 The treatment rate among hypertensive Filipino Americans (56.5 %) was also much lower when compared to NYC overall (72.7 %), nonHispanic Blacks (71.9 %), Hispanics (72.2 %), and Asians overall (73.2 %). 29 In our sample, only 21.7 % of hypertensive individuals exhibited hypertension control, a rate nearly half that of hypertensive adults in NYC overall (47.1 %), as well as Hispanics and non-Hispanic Blacks (both 46.8 %), and Asians overall (39.9 %).…”

“…29 The treatment rate among hypertensive Filipino Americans (56.5 %) was also much lower when compared to NYC overall (72.7 %), nonHispanic Blacks (71.9 %), Hispanics (72.2 %), and Asians overall (73.2 %). 29 In our sample, only 21.7 % of hypertensive individuals exhibited hypertension control, a rate nearly half that of hypertensive adults in NYC overall (47.1 %), as well as Hispanics and non-Hispanic Blacks (both 46.8 %), and Asians overall (39.9 %). 29 Similar to previous research in Filipino and other ethnic groups, older age was associated with a greater awareness of hypertension and treatment for hypertension, 18,27 having health insurance was associated with greater BP control, 15,27,30 lower self-rated health and comorbidities were associated with greater awareness of hypertension, 15,26 and smoking cigarettes was associated with not being on treatment for hypertension.…”

“…National Health and Nutrition Examination Survey (NHANES), National Health Interview Survey (NHIS), and the Veteran Affairs Medical Centers records). 26,29,32 The data for our study was drawn from a community-based sample of Filipino Americans at health screening events around the NY Metropolitan area. Measurements were taken directly by CHWs and licensed clinical nurses and reflect an exact measurement as opposed to self-reported diagnoses of hypertension.…”

“…15,18,20 Third, our screening survey did not include several important variables, including educational attainment, income, routine sources of health care, and knowledge regarding hypertension, which other studies have shown to be predictors of awareness, treatment, and control. 18,29,32,35,36 Finally, white coat hypertension could modify the prevalence of hypertension in the unaware group, since hypertension was defined using 1 day of BP readings. 2 Following recommendations, we took repeated measurements that were at least 3 min apart and used the last two out of three measurements to reduce the chance of wrongly detecting hypertension.…”