Undiagnosed and uncontrolled hypertension and hyperlipidemia among immigrants in the US.
Cardiovascular disease is a major cause of mortality and disability. We analyzed the National Health and Nutrition Examination Survey (1998-2008). We used logistic regression analysis to compare the odds of having undiagnosed and uncontrolled hypertension and hyperlipidemia among FB and US born adults sequentially adjusting for (1) age and gender, (2) income and education, and (3) insurance status. Among FB individuals, we identified factors independently associated with having each outcome using logistic regression analyses. Of 27,596 US adults, 22.6 % were foreign-born. In age- and -gender adjusted analyses, FB were more likely to have undiagnosed hypertension (OR 1.35, 95 % CI 1.13-1.63, p < 0.001), uncontrolled hypertension (OR 1.37, 95 % CI 1.15-1.64, p < 0.001), and uncontrolled hyperlipidemia (OR 1.35, 95 % CI 1.11-1.63, p = 0.002), while undiagnosed hyperlipidemia approached significance (OR 1.24, 95 % CI 0.99-1.56, p = 0.057). Having insurance was associated with a 5-15 % decrease in FB-US born disparities. Immigrants are at increased risk of undiagnosed and uncontrolled hypertension and hyperlipidemia.
Department of Medicine, Cambridge Health Alliance, and Harvard Medical School, Cambridge, MA 02139, USA. lzallman@challiance.org
Leah
L
Zallman
David H
DH
Himmelstein
Steffie
S
Woolhandler
David H
DH
Bor
John Z
JZ
Ayanian
Andrew P
AP
Wilper
Danny
D
McCormick
D000293:Adolescent; D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D054242:Emigrants and Immigrants; D005260:Female; D006306:Health Surveys; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology* / Q000208:ethnology; D006973:Hypertension / Q000453:epidemiology* / Q000208:ethnology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017211:Treatment Failure; D014481:United States / Q000453:epidemiology; D055815:Young Adult