title: Hypertension awareness, treatment, and control among diabetic and nondiabetic individuals in a multiethnic population in the Netherlands: the HELIUS study.
abstract: OBJECTIVE
  There is a paucity of data on hypertension awareness, treatment and control among diabetic adults from different ethnic backgrounds. We assessed ethnic differences in prevalence, awareness, treatment, and control of hypertension among diabetic adults and how they are compared with individuals without diabetes.
  
  
  METHODS
  Baseline data from the Healthy Life in an Urban Setting study were used including 12 ,633 adults aged 18-70 years from six ethnic backgrounds in Amsterdam, the Netherlands. Age-sex-adjusted prevalence ratios were used to explore ethnic differences.
  
  
  RESULTS
  Among diabetic individuals, African-Surinamese (80.2%; 1.26, 95% confidence interval 1.06-1.51) and Ghanaians (81.7%; 1.40, 1.17-1.68) were more likely than Dutch (69.6%) to have hypertension. There were no significant ethnic differences in the rates of awareness and treatment, but blood pressure (BP) control rates among treated hypertensives were significantly lower in Ghanaians (41.7%; 0.66, 0.45-0.96) and African-Surinamese (28.7%; 0.53, 0.34-0.84) than Dutch (54.1%). Among nondiabetic adults, except Moroccans, all the ethnic minorities had higher prevalence rates of hypertension, awareness (except South-Asian Surinamese and Turks) and treatment than Dutch people. By contrast, BP control rates among treated hypertensives were lower in all ethnic minorities, with the differences being significant for African-Surinamese (42.5%; 0.68, 0.57-0.80), South-Asian Surinamese (41.8%; 0.68, 0.57-0.82), and Ghanaians (35.2%; 0.54, 0.45-0.65).
  
  
  CONCLUSIONS
  Hypertension awareness and treatment rates are similar among ethnic groups in both diabetics and nondiabetics. Adequate BP control remains low among ethnic minorities, particularly among diabetic African origin people. Major effort is needed to improve BP control among diabetic people given the cardiovascular complications associated with uncontrolled BP in this group.
authors.affiliation: aDepartment of Public HealthbDepartment of Internal and Vascular MedicinecDepartment of Cardiology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Florence F
authors.initials: FF
authors.lastname: Fernald
authors.forename: Bert-Jan H
authors.initials: BJ
authors.lastname: van den Born
authors.forename: Marieke B
authors.initials: MB
authors.lastname: Snijder
authors.forename: Lizzy M
authors.initials: LM
authors.lastname: Brewster
authors.forename: Ron J
authors.initials: RJ
authors.lastname: Peters
authors.forename: Charles
authors.initials: C
authors.lastname: Agyemang
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D044466:Asian People / Q000706:statistics & numerical data; D001364:Awareness; D044383:Black People / Q000706:statistics & numerical data; D001794:Blood Pressure / Q000502:physiology; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D044465:White People
chemical_list: D000959:Antihypertensive Agents