Undiagnosed and Uncontrolled Hypertension and Hyperlipidemia among Immigrants in the US

• Published in: Journal of immigrant and minority health Vol. 15; no. 5; pp. 858 - 865
• Main Authors: Zallman, Leah, Himmelstein, David H., Woolhandler, Steffie, Bor, David H., Ayanian, John Z., Wilper, Andrew P., McCormick, Danny
• Format: Journal Article
• Language: English
• Published: Boston Springer Science + Business Media 01-10-2013; Springer US; Springer Nature B.V
• Subjects: Acculturation; Adolescent; Adult; Aged; Blood pressure; Cardiovascular disease; Cardiovascular diseases; Comparative Law; Confidence Intervals; Disability; Education; Emigrants and Immigrants; Fasting; Female; Gender; Guidelines; Health care policy; Health insurance; Health Surveys; Hispanic Americans; Humans; Hyperlipidemia; Hyperlipidemias - epidemiology; Hyperlipidemias - ethnology; Hypertension; Hypertension - epidemiology; Hypertension - ethnology; Immigrants; Insurance; International & Foreign Law; Laboratories; Logistic Models; Low Income; Low income groups; Male; Medicaid; Medical disorders; Medicine; Medicine & Public Health; Mexican Americans; Middle Aged; Minority & ethnic groups; Mortality; Noncitizens; Odds Ratio; ORIGINAL PAPER; Physical Examinations; Physicians; Pregnancy; Private International Law; Public Health; Regression (Statistics); Regression analysis; Socioeconomic factors; Sociology; Statistical analysis; Studies; Treatment Failure; Undiagnosed; Uninsured people; United States - epidemiology; Variables; Young Adult; United States; United States > US; USA; Hypertension; Hyperlipidemia; Immigrants
• ISSN: 1557-1912; 1557-1920
• DOI: 10.1007/s10903-012-9695-2

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.