Unequal Burden of Diabetes and Hypertension in the Adult Population of the San Juan Metropolitan Area of Puerto Rico

Abstract

Objective: The study describes critical information gaps regarding diabetes, hypertension, prediabetes, prehypertension and its comorbidities in a representative sample of the Hispanic adult population living in Puerto Rico. Research design and methods:A representative sample of non-institutionalized Puerto Ricans adults aged 18-79 years residing in the San Juan metropolitan area participated in a face-to-face interview, anthropometric measurements and blood draws. Prevalence of diabetes, hypertension, prediabetes, and prehypertension were estimated using logistic regression. Levels of awareness, treatment, adherence to medications, and control of these conditions were assessed.Results: Of 452 participants, 15.2% had diabetes, 35.3% had pre-diabetes, 39.9% had hypertension and 44.9% had pre-hypertension. Females were more likely to have diabetes, except those aged 18-64 years. Prevalence of diabetes, pre-diabetes, hypertension and pre-hypertension increased significantly with age in both sexes. Prehypertension was more prevalent among males in all age groups. Only 35% of those diagnosed with diabetes and 52.5% of those diagnosed with hypertension were controlled on pharmacotherapy. Conclusions:There is an unequal burden of diabetes, pre-diabetes, hypertension and pre-hypertension in Puerto Rico. The prevalence is high, increased significantly with age, and although the vast majority of participants with diabetes and hypertension were under treatment, control rates are suboptimal. These findings underscore the need for continued physician's efforts to improve control rates in our population.

Aging in Puerto Rico: A Comparison of Health Status Among Island Puerto Rican and Mainland U.S. Older Adults

“…In fact, hypertension is higher among island Puerto Ricans than U.S. Hispanics (Rodriguez et al, 2016), and diabetes in Puerto Rico is higher than in many other Latin American countries (Salas et al, 2016). The higher levels of hypertension and diabetes observed among the older island Puerto Rican population may pose challenges for caregivers, families, health agencies, and governments in this rapidly aging population (Allende-Vigo et al, 2013). …”

Transculturalization Recommendations For Developing Latin American Clinical Practice Algorithms In Endocrinology Proceedings Of The 2015 Pan-American Workshop By The American Association Of Clinical Endocrinologists And American College Of Endocrinology

“…In Costa Rica, however, where near universal health care coverage benefits 98% of the population, there is still a growing prevalence of diabetes (now 9.8%), with a need for improved primary prevention strategies (54,55). According to a recent study, the overall prevalence of T2D in the adult population in the San Juan metropolitan area of Puerto Rico was 15.2%, the overall prevalence of overweight (BMI 25.0 to 29.9 kg/m 2 ) was 34.7%, and the overall prevalence of obesity (BMI ≥30 kg/ m 2 ) was 43.8% (56). Each of these figures is relatively high on the world stage and depicts a very troubling health care scenario for Puerto Rico.…”