Hypertension rising among older Mexican-Americans

Al Ghatrif M. Ann Epidemiol. 2011;21:15-25.

Issue: February 2011

Hypertension, due mainly to obesity and diabetes, is increased slightly in older Mexican-Americans living in the southwestern United States, researchers have found.

Researchers at the University of Texas Medical Branch at Galveston compared rates of self-reported hypertension and measured blood pressure, medications, sociodemographic and other health-related factors in two separate cross-sectional cohorts of non-institutionalized Mexican-Americans aged 75 years or older. All participants were living in Texas, New Mexico, Colorado, Arizona or California. The data for both cohorts (cohort 1, 1993-1994, n=919; cohort 2, 2004-2005, n=738) were taken from the Hispanic Established Population for the Epidemiological Study of the Elderly (Hispanic-EPESE).

Hypertension prevalence increased from 73% in 1993 to 1994 to 78.4% in 2004 to 2005. Prevalent rates were significant for those aged 75 to 79 years (cohort 1, 70.5%; cohort 2, 80.5%), for those born in the US (cohort 1, 70.6%; cohort 2, 81.6%), for those with diabetes (cohort 1, 77.6%; cohort 2, 90%), and for the obese (cohort 1, 81.8%; cohort 2, 89.7%).

Cross-cohort multivariate logistic regression analyses indicated that the OR for hypertension trends in 1993 to 1994, when adjusting for age and sex, was 1.44 (95% CI, 1.03-2.01). The age- and gender-adjusted OR for 2004 to 2005 was 1.29 (95% CI, 0.90-1.85) and 1.35 (95% CI, 0.96-1.895), respectively, when diabetes and obesity were factored into the model.

Despite slight increases in the prevalence of hypertension, the researchers found that awareness and management also increased. Hypertension awareness was higher in recent years (82.6%) than in the 1990s (63%). There was also an increase in hypertension control in 2004 to 2005 when compared with 1993 to 1994 (55.4% vs. 42.5%). Cross-cohort multivariate analyses indicated that the higher odds of control in more recent years were reduced when diabetes was factored into the model. Treatment rates did not change significantly from one cohort to the next (62.2% to 65.6%).

“More effort should be targeted to reverse trends of both obesity and diabetes as potential causes of increases in hypertension,” researchers wrote. “Further investigations should be directed toward providing clear guidelines and goals for hypertension treatment and control in the very old to improve hypertension outcomes in this population.”

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