Correlates of hypertension among Chippewa and Menominee Indians, the Inter-Tribal Heart Project.
OBJECTIVE
The objective of this study was to document the prevalence and control of hypertension among Chippewa and Menominee Indians who participated in the Inter-Tribal Heart Project (ITHP), and to identify the covariates of controlled hypertension in this population.


METHODS
Participants responded to an interviewer-administered questionnaire and underwent a physical examination and laboratory screening.


METHODS
A random sample of 1376 individuals aged > or = 25 years who were active users of the Indian Health Service clinics on the Chippewa and Menominee Reservations and participated in the ITHP.


RESULTS
The prevalence of hypertension (systolic blood pressure [SBP] > or = 140 mm Hg and/ or diastolic blood pressure [DBP] > or = 90 mm Hg and/or currently taking anti-hypertension medications) was 31%. Approximately 25% of individuals with hypertension were unaware of their hypertensive status. Among hypertensives, 58% reported currently using anti-hypertension medications, and only 28% had blood pressures below the recommended levels (SBP < 140 mm Hg or DBP < 90 mm Hg).


CONCLUSIONS
The high prevalence of hypertension coupled with the low prevalence of controlled hypertension suggests the need to enhance and strengthen programs that target hypertension prevention and control. These programs should include pharmacologic and non-pharmacologic approaches, as well as culturally appropriate programs that incorporate beliefs held by American Indians about hypertension causation, manifestations and treatment, in an attempt to reduce this group's burden of hypertension.
Welch
Verna L Lamar
VL
Emory Center on Health Outcomes and Quality, Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA. vlamar@sph.emory.edu
Casper
Michele L
ML
Rith-Najarian
Stephen J
SJ
D000328:Adult; D005260:Female; D006303:Health Services, Indigenous; D006305:Health Status Indicators; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000208:ethnology*; D007198:Indians, North American; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011897:Random Allocation; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D016549:United States Indian Health Service