Blood pressure control, hypertension, awareness, and treatment in adults with diabetes in the United States-Mexico border region.
OBJECTIVE
To determine prevalence of blood pressure control, hypertension, hypertension awareness, and antihypertensive treatment among adults (> 18 years old) with diabetes living in the border region between the United States of America and Mexico, and to explore variation in those variables between all adults on the Mexican side of the border ("Mexicans") and three groups on the U.S. side of the border ("all U.S. adults," "U.S.-born Hispanics," and "Mexican immigrants").


METHODS
Using data from Phase I (February 2001-October 2002) of the U.S.-Mexico Border Diabetes Prevention and Control Project, a prevalence study of type 2 diabetes and its risk factors, age-adjusted prevalence of hypertension-related variables was calculated for the sample (n = 682) and differences between the border groups were examined through logistic regression.


RESULTS
Less than one-third of the sample had controlled blood pressure (< 130/80 mm Hg), almost half had hypertension (≥140/90 mm Hg), and hypertension awareness and treatment were inadequate. After adjusting for demographics, body mass index, and access to health care, there were no differences in blood pressure control, hypertension, hypertension awareness, or treatment between Mexicans and both U.S. adults and Mexican immigrants. However, compared to Mexicans and Mexican immigrants, U.S.-born Hispanics, particularly younger individuals, had the lowest rates of blood pressure control (17.3%) and the highest rates of coexisting hypertension (54.8%). Compared to Mexicans, U.S.-born Hispanics had lower odds of controlled blood pressure (odds ratio [OR] 0.30, 95% confidence interval [CI] 0.09-0.95) and greater odds of hypertension (OR 3.75, 95% CI 1.51-9.29) and hypertension awareness (OR 6.19, 95% CI 1.46-26.15).


CONCLUSIONS
Co-occurrence of diabetes and hypertension is a major public health problem among U.S.-Mexico border residents. The low rate of blood pressure control among various border groups, especially younger U.S.-born Hispanics, suggests that initiatives should aggressively target blood pressure control.
Vijayaraghavan
Maya
M
Division of General Internal Medicine, University of California-San Francisco, San Francisco, California, USA.
He
Guozhong
G
Stoddard
Pamela
P
Schillinger
Dean
D
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D015992:Body Mass Index; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data; D008800:Mexico / Q000453:epidemiology / Q000208:ethnology; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors; D015206:Southwestern United States / Q000453:epidemiology
D000959:Antihypertensive Agents