Skip to main content
Top
Published in: Journal of General Internal Medicine 8/2010

01-08-2010 | Original Research

Hypertension and Diabetes Prevalence Among U.S. Hispanics by Country of Origin: The National Health Interview Survey 2000-2005

Authors: Lina P. Pabon-Nau, MD, MPH, Amy Cohen, BA, James B. Meigs, MD, MPH, Richard W. Grant, MD, MPH

Published in: Journal of General Internal Medicine | Issue 8/2010

Login to get access

Abstract

Background

Despite their diverse cultural origins, Hispanics in the US are generally studied as a single ethnic group.

Objectives

1) Assess demographic and disease-related differences among U.S. Hispanics by country of origin, and 2) Examine the mediating roles of socioeconomic status and acculturation on disease prevalence in these subgroups.

Design and Participants

Using data from the 2000-2005 National Health Interview Survey (NHIS), we compared characteristics of Mexican-Americans with Hispanics originally from: Mexico, Puerto Rico, Central/South America, Cuba, and Dominican Republic (n = 31,240). We stratified the analysis by foreign versus US-born Hispanic subgroups and modeled hypertension and diabetes prevalence, adjusting for demographic and acculturation differences.

Main results

The six Hispanic subgroups were significantly diverse in all measured variables. Prevalence of hypertension (32%) and diabetes (15%) was highest in foreign-born Puerto Ricans. After adjusting for age, BMI, smoking, socioeconomic status and acculturation in foreign-born Hispanics, Puerto Ricans (OR = 1.76 [95% CI: 1.23, 2.50], p = 0.002) and Dominicans (OR = 1.93 [1.24, 3.00], p = 0.004), had higher prevalence of hypertension relative to Mexican-Americans. Adjusted diabetes prevalence among foreign-born Hispanics was half or less in Cubans (OR = 0.42 [0.25, 0.68] p < 0.001), Dominicans (OR = 0.48 [0.26, 0.91], p = 0.02) and Central/South Americans (OR = 0.51 [0.33, 0.78], p = 0.002) relative to Mexican-Americans. Among US-born Hispanic subgroups, Cubans had lower hypertension (OR = 0.53, [0.33, 0.83], p = 0.006) and Mexicans (OR = 0.76 [0.60, 0.98], p = 0.03) had lower diabetes prevalence compared to Mexican-Americans in adjusted models.

Conclusions

The prevalence of hypertension and diabetes varies significantly among Hispanics by country of origin. Health disparities research should include representation from all Hispanic subgroups.
Appendix
Available only for authorised users
Literature
2.
go back to reference Gu Q, Burt VL, Paulose-Ram R, Yoon S, Gillum RF. High blood pressure and cardiovascular disease mortality risk among U.S. adults: the third National Health and Nutrition Examination Survey mortality follow-up study. Ann Epidemiol. 2008;18(4):302–9.CrossRefPubMed Gu Q, Burt VL, Paulose-Ram R, Yoon S, Gillum RF. High blood pressure and cardiovascular disease mortality risk among U.S. adults: the third National Health and Nutrition Examination Survey mortality follow-up study. Ann Epidemiol. 2008;18(4):302–9.CrossRefPubMed
3.
go back to reference Ong KL, Cheung BM, Man YB, Lau CP, Lam KS. Prevalence, awareness, treatment, and control of hypertension among United States adults 1999-2004. Hypertension. 2007;49(1):69–75.CrossRefPubMed Ong KL, Cheung BM, Man YB, Lau CP, Lam KS. Prevalence, awareness, treatment, and control of hypertension among United States adults 1999-2004. Hypertension. 2007;49(1):69–75.CrossRefPubMed
4.
go back to reference Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000. JAMA. 2003;290(2):199–206.CrossRefPubMed Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000. JAMA. 2003;290(2):199–206.CrossRefPubMed
5.
go back to reference Burt VL, Whelton P, Rocella EJ, et al. Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988-1991. Hypertension. 1995;25(3):305–13.PubMed Burt VL, Whelton P, Rocella EJ, et al. Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988-1991. Hypertension. 1995;25(3):305–13.PubMed
6.
go back to reference Glover MJ, Greenlund KJ, Ayala C, Croft JB. Racial/ethnic disparities in prevalence, treatment, and control of Hypertension:United States; 1999–2002. Morb Mortal Wkly Rep. 2005;54:7–9. Glover MJ, Greenlund KJ, Ayala C, Croft JB. Racial/ethnic disparities in prevalence, treatment, and control of Hypertension:United States; 1999–2002. Morb Mortal Wkly Rep. 2005;54:7–9.
7.
go back to reference Cowie CC, Rust KF, Byrd-Holt DD, et al. Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population: National Health and Nutrition Examination Survey 1999-2002. Diabetes Care. 2006;29(6):1263–8.CrossRefPubMed Cowie CC, Rust KF, Byrd-Holt DD, et al. Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population: National Health and Nutrition Examination Survey 1999-2002. Diabetes Care. 2006;29(6):1263–8.CrossRefPubMed
8.
go back to reference McBean AM, Li S, Gilbertson DT, Collins AJ. Differences in diabetes prevalence, incidence, and mortality among the elderly of four racial/ethnic groups: whites, blacks,Hispanics, and Asians. Diabetes Care. 2004;27(10):2317–24.CrossRefPubMed McBean AM, Li S, Gilbertson DT, Collins AJ. Differences in diabetes prevalence, incidence, and mortality among the elderly of four racial/ethnic groups: whites, blacks,Hispanics, and Asians. Diabetes Care. 2004;27(10):2317–24.CrossRefPubMed
9.
go back to reference Kirk JK, Passmore LV, Bell RA, et al. Disparities in A1C levels between Hispanic and non-Hispanic white adults with diabetes: a meta-analysis. Diabetes Care. 2008;31(2):240–6.CrossRefPubMed Kirk JK, Passmore LV, Bell RA, et al. Disparities in A1C levels between Hispanic and non-Hispanic white adults with diabetes: a meta-analysis. Diabetes Care. 2008;31(2):240–6.CrossRefPubMed
10.
go back to reference Herman WH, Ma Y, Uwaifo G, Diabetes Prevention Program Research Group, et al. Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the Diabetes Prevention Program. Diabetes Care. 2007;30(10):2453–7.CrossRefPubMed Herman WH, Ma Y, Uwaifo G, Diabetes Prevention Program Research Group, et al. Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the Diabetes Prevention Program. Diabetes Care. 2007;30(10):2453–7.CrossRefPubMed
11.
go back to reference Wendel CS, Shah JH, Duckworth WC, Hoffman RM, Mohler MJ, Murata GH. Racial and ethnic disparities in the control of cardiovascular disease risk factors in Southwest American veterans with type 2 diabetes: the Diabetes Outcomes Veterans Study. BMC Health Serv Res. 2006;6:58.CrossRefPubMed Wendel CS, Shah JH, Duckworth WC, Hoffman RM, Mohler MJ, Murata GH. Racial and ethnic disparities in the control of cardiovascular disease risk factors in Southwest American veterans with type 2 diabetes: the Diabetes Outcomes Veterans Study. BMC Health Serv Res. 2006;6:58.CrossRefPubMed
12.
go back to reference Bonds DE, Zaccaro DJ, Karter AJ, Selby JV, Saad M, Goff DC Jr. Ethnic and racial differences in diabetes care: The Insulin Resistance Atherosclerosis Study. Diabetes Care. 2003;26(4):1040–6.CrossRefPubMed Bonds DE, Zaccaro DJ, Karter AJ, Selby JV, Saad M, Goff DC Jr. Ethnic and racial differences in diabetes care: The Insulin Resistance Atherosclerosis Study. Diabetes Care. 2003;26(4):1040–6.CrossRefPubMed
13.
go back to reference Hertz RP, Unger AN, Ferrario CM. Diabetes, hypertension, and dyslipidemia in Mexican Americans and non-Hispanic whites. Am J Prev Med. 2006;30(2):103–10.CrossRefPubMed Hertz RP, Unger AN, Ferrario CM. Diabetes, hypertension, and dyslipidemia in Mexican Americans and non-Hispanic whites. Am J Prev Med. 2006;30(2):103–10.CrossRefPubMed
14.
go back to reference Jiang HJ, Stryer D, Friedman B, Andrews R. Multiple hospitalizations for patients with diabetes. Diabetes Care. 2003;26(5):1421–6.CrossRefPubMed Jiang HJ, Stryer D, Friedman B, Andrews R. Multiple hospitalizations for patients with diabetes. Diabetes Care. 2003;26(5):1421–6.CrossRefPubMed
15.
go back to reference Young BA, Maynard C, Reiber G, Boyko EJ. Effects of ethnicity and nephropathy on lower-extremity amputation risk among diabetic veterans. Diabetes Care. 2003;26(2):495–501.CrossRefPubMed Young BA, Maynard C, Reiber G, Boyko EJ. Effects of ethnicity and nephropathy on lower-extremity amputation risk among diabetic veterans. Diabetes Care. 2003;26(2):495–501.CrossRefPubMed
16.
go back to reference Meigs JB, Wilson PW, Nathan DM, D'Agostino RB Sr, Williams K, Haffner SM. Prevalence and characteristics of the metabolic syndrome in the San Antonio Heart and Framingham Offspring Studies. Diabetes. 2003;52(8):2160–7.CrossRefPubMed Meigs JB, Wilson PW, Nathan DM, D'Agostino RB Sr, Williams K, Haffner SM. Prevalence and characteristics of the metabolic syndrome in the San Antonio Heart and Framingham Offspring Studies. Diabetes. 2003;52(8):2160–7.CrossRefPubMed
17.
go back to reference Lorenzo C, Williams K, Hunt KJ. Haffner SM. Trend in the prevalence of the metabolic syndrome and its impact on cardiovascular disease incidence: the San Antonio Heart Study. Diabetes Care. 2006;29(3):625–30.CrossRefPubMed Lorenzo C, Williams K, Hunt KJ. Haffner SM. Trend in the prevalence of the metabolic syndrome and its impact on cardiovascular disease incidence: the San Antonio Heart Study. Diabetes Care. 2006;29(3):625–30.CrossRefPubMed
18.
go back to reference Hajat A, Lucas JB, Kington R. Health outcomes among Hispanic subgroups:data from the National Health Interview Survey, 1992–1995. Adv Data. 2000;25(310):1–14. Hajat A, Lucas JB, Kington R. Health outcomes among Hispanic subgroups:data from the National Health Interview Survey, 1992–1995. Adv Data. 2000;25(310):1–14.
19.
go back to reference Smith CA, Barnett E. Diabetes-related mortality among Mexican Americans, Puerto Ricans, and Cuban Americans in the United States. Rev Panam Salud Publica. 2005;18(6):381–7.CrossRefPubMed Smith CA, Barnett E. Diabetes-related mortality among Mexican Americans, Puerto Ricans, and Cuban Americans in the United States. Rev Panam Salud Publica. 2005;18(6):381–7.CrossRefPubMed
20.
go back to reference Pappas G, Gergen PJ, Caroll M. Hypertension prevalence and the status of awareness, treatment, and control in the Hispanic Health and Nutrition Examination Survey (HHANES), 1982-1984. Am J Public Health. 1990;80(12):1431–6.CrossRefPubMed Pappas G, Gergen PJ, Caroll M. Hypertension prevalence and the status of awareness, treatment, and control in the Hispanic Health and Nutrition Examination Survey (HHANES), 1982-1984. Am J Public Health. 1990;80(12):1431–6.CrossRefPubMed
21.
go back to reference Crespo CJ, Loria CM, Burt VL. Hypertension and other cardiovascular disease risk factors among Mexican Americans, Cuban Americans, and Puerto Ricans from the Hispanic Health and Nutrition Examination Survey. Public Health Rep. 1996;111(Suppl 2):7–10.PubMed Crespo CJ, Loria CM, Burt VL. Hypertension and other cardiovascular disease risk factors among Mexican Americans, Cuban Americans, and Puerto Ricans from the Hispanic Health and Nutrition Examination Survey. Public Health Rep. 1996;111(Suppl 2):7–10.PubMed
22.
go back to reference Flegal KM, Ezzati TM. Prevalence of diabetes in Mexican Americans, Cubans, and Puerto Ricans from the Hispanic Health and Nutrition Examination Survey, 1982-1984. Diabetes Care. 1991;14(7):628–38.CrossRefPubMed Flegal KM, Ezzati TM. Prevalence of diabetes in Mexican Americans, Cubans, and Puerto Ricans from the Hispanic Health and Nutrition Examination Survey, 1982-1984. Diabetes Care. 1991;14(7):628–38.CrossRefPubMed
23.
go back to reference Allison MA, Budoff MJ, Wong ND, Blumenthal RS, Schreiner PJ, Criqui MH. Prevalence and risk factors for subclinical cardiovascular disease in selected US Hispanic ethnic groups: the Multi-Ehtnic Study of Atherosclerosis. Am J Epidemiol. 2008;167(8):962–9.CrossRefPubMed Allison MA, Budoff MJ, Wong ND, Blumenthal RS, Schreiner PJ, Criqui MH. Prevalence and risk factors for subclinical cardiovascular disease in selected US Hispanic ethnic groups: the Multi-Ehtnic Study of Atherosclerosis. Am J Epidemiol. 2008;167(8):962–9.CrossRefPubMed
24.
go back to reference Pickering TG. Hypertension in Hispanics. J Clin Hypertens (Greenwich). 2004;6(5):279–82.CrossRef Pickering TG. Hypertension in Hispanics. J Clin Hypertens (Greenwich). 2004;6(5):279–82.CrossRef
27.
go back to reference Moran A, Roux AV, Jackson SA, Kramer H, Manolio TA, Shrager S, Shea S. Acculturation is associated with hypertension in a multiethnic sample. Am J Hypertens. 2007;20(4):354–63.CrossRefPubMed Moran A, Roux AV, Jackson SA, Kramer H, Manolio TA, Shrager S, Shea S. Acculturation is associated with hypertension in a multiethnic sample. Am J Hypertens. 2007;20(4):354–63.CrossRefPubMed
28.
go back to reference Kandula NR, Diez-Roux AV, Chan C, Daviglus ML, Jackson SA, Ni H, Schreiner PJ. Association of acculturation levels and prevalence of diabetes in the multi-ethnic study of atherosclerosis (MESA). Diabetes Care. 2008;31(8):1621–8.CrossRefPubMed Kandula NR, Diez-Roux AV, Chan C, Daviglus ML, Jackson SA, Ni H, Schreiner PJ. Association of acculturation levels and prevalence of diabetes in the multi-ethnic study of atherosclerosis (MESA). Diabetes Care. 2008;31(8):1621–8.CrossRefPubMed
29.
go back to reference Singh GK, Siahpush M. All-Cause and Cause-Specific Mortality of Immigrants and Native Born in the United States. Am J Public Health. 2001;91(3):392–9.CrossRefPubMed Singh GK, Siahpush M. All-Cause and Cause-Specific Mortality of Immigrants and Native Born in the United States. Am J Public Health. 2001;91(3):392–9.CrossRefPubMed
30.
go back to reference Thamer M, Richard C, Casebeer AW, Ray NF. Health Insurance Coverage among Foreign-Born US Residents: The Impact of Race, Ethnicity, and Length of Residence. Am J Public Health. 1997;87(1):96–102.CrossRefPubMed Thamer M, Richard C, Casebeer AW, Ray NF. Health Insurance Coverage among Foreign-Born US Residents: The Impact of Race, Ethnicity, and Length of Residence. Am J Public Health. 1997;87(1):96–102.CrossRefPubMed
31.
go back to reference Gordon-Larsen P, Harris KM, Ward DS, Popkin BM. Acculturation and overweight-related behaviors among Hispanic immigrants to the US: the National Longitudinal Study of Adolescent Health. Soc Sci Med. 2003;57(11):2023–34.CrossRefPubMed Gordon-Larsen P, Harris KM, Ward DS, Popkin BM. Acculturation and overweight-related behaviors among Hispanic immigrants to the US: the National Longitudinal Study of Adolescent Health. Soc Sci Med. 2003;57(11):2023–34.CrossRefPubMed
33.
go back to reference Abraido-Lanza AF, Dohrenwend BP, Ng-Mak DS, Turner B. The Latino Mortality paradox: a test of the “Salmon Bias” and healthy migrant hypothesis. Am J Public Health. 1999;89(10):1543–8.CrossRefPubMed Abraido-Lanza AF, Dohrenwend BP, Ng-Mak DS, Turner B. The Latino Mortality paradox: a test of the “Salmon Bias” and healthy migrant hypothesis. Am J Public Health. 1999;89(10):1543–8.CrossRefPubMed
34.
go back to reference Abraido-Lanza, Armbrister AN, Florez KR, Aguirre AN. Toward a theory-driven model of acculturation in public health research. Am J Health. 2006;96:1342–6.CrossRef Abraido-Lanza, Armbrister AN, Florez KR, Aguirre AN. Toward a theory-driven model of acculturation in public health research. Am J Health. 2006;96:1342–6.CrossRef
35.
go back to reference Borrell LN, Crawford N, Huynh M, Dumanovsky T. Self-reported hypertension and race among Hispanic and non-Hispanic adults: The New York City Community Health Survey. Ethn Dis. 2008;18:299–305.PubMed Borrell LN, Crawford N, Huynh M, Dumanovsky T. Self-reported hypertension and race among Hispanic and non-Hispanic adults: The New York City Community Health Survey. Ethn Dis. 2008;18:299–305.PubMed
36.
go back to reference Borrell LN. Self reported hypertension and race among Hispanics in the National Health Interview Survey. Ethn Dis. 2006;16:71–7.PubMed Borrell LN. Self reported hypertension and race among Hispanics in the National Health Interview Survey. Ethn Dis. 2006;16:71–7.PubMed
37.
go back to reference Getaneh A, Michelen W, Findley S. The prevalence of cardiovascular risk conditions and awareness among a Latino Subgroup: Dominican in Northern Manhattan. Ethn Dis. 2008;18:342–7.PubMed Getaneh A, Michelen W, Findley S. The prevalence of cardiovascular risk conditions and awareness among a Latino Subgroup: Dominican in Northern Manhattan. Ethn Dis. 2008;18:342–7.PubMed
38.
go back to reference González Burchard E, Borrell LN, Choudhry S, et al. Latino populations: a unique opportunity for the study of race, genetics, and social environment in epidemiological research. Am J Public Health. 2005;95(12):2161–8.CrossRefPubMed González Burchard E, Borrell LN, Choudhry S, et al. Latino populations: a unique opportunity for the study of race, genetics, and social environment in epidemiological research. Am J Public Health. 2005;95(12):2161–8.CrossRefPubMed
39.
go back to reference Goel MS, McCarthy EP, Phillips RS, Wee CC. Obesity among US immigrant subgroups by duration of residence. JAMA. 2004;292:2860–7.CrossRefPubMed Goel MS, McCarthy EP, Phillips RS, Wee CC. Obesity among US immigrant subgroups by duration of residence. JAMA. 2004;292:2860–7.CrossRefPubMed
40.
go back to reference Kaplan MS, Huguet N, Newsom JT, McFarland BH. The association between length of residence and obesity among Hispanic immigrants. Am J Prev Med. 2004;27:323–32626.CrossRefPubMed Kaplan MS, Huguet N, Newsom JT, McFarland BH. The association between length of residence and obesity among Hispanic immigrants. Am J Prev Med. 2004;27:323–32626.CrossRefPubMed
41.
go back to reference Perez-Escamilla R, Putnik P. The role of acculturation in nutrition, lifestyle, and incidence of type 2 diabetes among Latinos. J Nutr. 2007;137(4):860–70.PubMed Perez-Escamilla R, Putnik P. The role of acculturation in nutrition, lifestyle, and incidence of type 2 diabetes among Latinos. J Nutr. 2007;137(4):860–70.PubMed
42.
go back to reference Giles WH, Croft JB, Keenan NL, Lane MJ, Wheeler FC. The validity of self-reported hypertension and correlates of hypertension awareness among Blacks and Whites within the stroke belt. Am J Prev Med. 1995;11:163–9.PubMed Giles WH, Croft JB, Keenan NL, Lane MJ, Wheeler FC. The validity of self-reported hypertension and correlates of hypertension awareness among Blacks and Whites within the stroke belt. Am J Prev Med. 1995;11:163–9.PubMed
43.
go back to reference Vargas CM, Burt VL, Gillum RF, Pamuk ER. Validity of self-reported hypertension in the National Health and Nutrition Examination Survey III, 1988-1991. Prev Med. 1997;26(5 Pt 1):678–85.CrossRefPubMed Vargas CM, Burt VL, Gillum RF, Pamuk ER. Validity of self-reported hypertension in the National Health and Nutrition Examination Survey III, 1988-1991. Prev Med. 1997;26(5 Pt 1):678–85.CrossRefPubMed
Metadata
Title
Hypertension and Diabetes Prevalence Among U.S. Hispanics by Country of Origin: The National Health Interview Survey 2000-2005
Authors
Lina P. Pabon-Nau, MD, MPH
Amy Cohen, BA
James B. Meigs, MD, MPH
Richard W. Grant, MD, MPH
Publication date
01-08-2010
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue 8/2010
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-010-1335-8

Other articles of this Issue 8/2010

Journal of General Internal Medicine 8/2010 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine