Far fewer Hispanic adults who suffer from high blood pressure (hypertension, greater than 140/90 mm Hg) use antihypertensive medications to control it than do white or black adults who have the condition. This difference is not explained by lack of insurance, lower socioeconomic status, or adverse health orientations and habits, according to the findings from a recent study by Case Western Reserve University researchers Joseph J. Sudano Jr., Ph.D., and David W. Baker, M.D., M.P.H. The study was supported by the Agency for Healthcare Research and Quality (HS10283).
The researchers used data from the 1992 U.S. Health and Retirement Study to analyze differences in self-reported antihypertensive medication use by white, Hispanic, and black adults aged 51 to 61 years with a history of hypertension. A total of 53 percent of Hispanics, 64 percent of whites, and 73 percent of blacks with high blood pressure reported taking antihypertensive medications. Adjusting for differences in demographics, socioeconomic status, insurance coverage, and health status did not significantly alter the relation between Hispanic ethnicity and lower use of antihypertensive medication.
These findings raise serious concerns that hypertension control efforts by public health and health care agencies have failed to reach this important and growing segment of the U.S. population, note the researchers. They suggest several possible reasons for less use of antihypertensive medications by Hispanics, including discrimination within medical care institutions or in medical encounters, few Hispanic health professionals and researchers, few culturally sensitive primary prevention programs targeted to Hispanics, and lack of media awareness of Hispanic health issues. The authors note that some of these same factors may also apply to black adults (e.g., potential discrimination, physician bias in treatment, underrepresentation among health professionals). Thus, it is somewhat surprising that black adults were actually more likely than Hispanic adults and white adults to report taking antihypertensive medication.
It's possible that efforts to educate blacks and health care professionals about the high incidence of hypertension among blacks may have been successful, note Drs. Sudano and Baker. They conclude that similar efforts are needed for Hispanics, including programs to educate Hispanics about the importance of taking medication and making lifestyle changes to control their blood pressure.
More details are in "Antihypertensive medication use in Hispanic adults: A comparison with black adults and white adults," by Drs. Sudano and Baker, in the June 2001 Medical Care 39(6), pp. 575-587.