Awareness of hypertension and diabetes in the Hispanic community

doi:10.1016/S1098-3597(04)80060-7

Clinical Cornerstone

Volume 6, Issue 3, 2004, Pages 7-15

https://doi.org/10.1016/S1098-3597(04)80060-7 Get rights and content

Major barriers to awareness and control of hypertension and diabetes in Hispanic Americans include poor language comprehension, poor physician—patient communication, cultural differences, low educational level, and lack of health insurance. To better communicate the concerns about the risk factors for cardiovascular disease, physicians could use patient-education materials that include illustrations, familiarize themselves with their Hispanic patients and their preferences regarding communication (eg, formality, close proximity, appropriately used touch), and advocate government action to make health insurance more affordable. An increase in Spanish-speaking physicians would help alleviate some of the confusion that Hispanic patients experience in their interactions with health care providers.

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Latinos are at an increased risk of hypertension-related disparities. Biological, behavioral, cultural, and structural factors have been identified as underlying mechanisms driving these disparities. However, the influence of Latino settlement patterns on hypertension management practices has been rarely explored, particularly from a qualitative lens. Using data from semi-structured interviews conducted with Latinos with hypertension (n = 26), we sought to develop a comprehensive understanding of the social and contextual factors influencing Latinos' hypertension management practices in new and established Latino destination states (Iowa and California, respectively). Participants described hypertension management as a complex phenomenon being influenced by factors at each level of the ecological model. However, some factors were more salient depending on place of residence. Specifically, while Latinos in Iowa were more likely to discuss how challenges of being an immigrant impacted their hypertension management, those in California had a preference to talk about how culture shapes the way they manage their hypertension. This study extends efforts to identify the underlying mechanisms driving Latinos' hypertension-related disparities. Results highlight the need to consider place of residence as a key contextual factor. Tailoring interventions to place may be necessary to effectively address Latinos’ hypertension-related needs.
Evidence-based nursing practice for health promotion in adults with hypertension: A literature review
2010, Asian Nursing Research
This paper is a report of the results of a literature review conducted with the goal of identifying the nursing process components: assessment, diagnoses, interventions and outcomes related to health promotion in adults with hypertension in primary settings.
A search of MEDLINE, CINAHL, and PantherCat Online Catalogue of UWM database, PsycInfo, Cochrane Database, and Social Services Abstracts was conducted to retrieve literature published from 1988 to 2006.
A total of 115 articles were reviewed. Overall, 70 relevant studies were selected on health promotion in adults with hypertension in primary settings. A total of 39 nursing process components (nursing diagnoses outcomes and interventions) related to health promotion with adults with high blood pressure were identified in primary healthcare settings.
Research-based evidence material provides an evidence-based nursing practice guideline with specific nursing process components on the topic. The evidence-based nursing practice guideline developed from this referential study for promoting health of adults with hypertension should be reflected in nursing practice in primary healthcare settings. For a future study, focus groups and key informant interview are recommended with nurses who actually provide nursing services in primary healthcare settings to clients who are diagnosed with high blood pressure.
Accuracy of Patients' Reports of Comorbid Disease and Their Association With Mortality in ESRD
2008, American Journal of Kidney Diseases
Patient awareness of chronic diseases is low. Unawareness may represent poor understanding of chronic illness and may be associated with poor outcomes in patients with end-stage renal disease (ESRD).
Concurrent prospective national cohort study.
Incident hemodialysis and peritoneal dialysis patients enrolled in the Choices for Healthy Outcomes in Caring for ESRD Study and followed up until 2004.
Inaccurate patient self-report of 8 comorbid diseases compared with the medical record.
All-cause mortality was the primary outcome. Cox proportional hazard models were used to assess the contribution of demographics and clinical measures in the relation of inaccurate self-report to mortality.
In 965 patients, the proportion of inaccurate self-reporters ranged from 3% for diabetes mellitus to 35% for congestive heart failure. Generally, inaccurate self-reporters were older and had more chronic diseases. Greater risk of death was found for inaccurate self-reporters of ischemic heart disease (hazard ratio [HR], 1.34; 95% confidence interval, 1.12 to 1.59; P = 0.001), coronary intervention (HR, 1.46; 95% confidence interval, 1.08 to 1.97; P = 0.01), and chronic obstructive pulmonary disease (HR, 1.40; 95% confidence interval, 1.14 to 1.70; P = 0.001). The greater risk of death remained significant for chronic obstructive pulmonary disease (HR, 1.36; 95% confidence interval, 1.11 to 1.66; P = 0.003) after adjustment for age, sex, and race. In patients receiving peritoneal dialysis, greater risk of death (HR, 2.06; 95% confidence interval, 1.34 to 3.15; P = 0.001) was found for inaccurate self-reporters of ischemic heart disease.
Includes potential for residual confounding, medical record error, misclassification of patient accuracy of self-report, and low inaccurate self-report of some chronic diseases, reducing the power to measure associations.
Accuracy of self-report depends on the specific comorbid disease. Patients with ESRD, especially those receiving peritoneal dialysis, who inaccurately report heart disease may be less aware of their chronic comorbid disease and may be at greater risk of mortality compared with those who accurately report their comorbid disease.
People awareness about diabetes disease and its complications among aged 18 years and older in Bushehr port inhabitants (Iran)
2007, Diabetes and Metabolic Syndrome: Clinical Research and Reviews
Citation Excerpt :
In Australia a study that was carried out among the general population of Australian showed a higher level of awareness of the ocular effects of diabetes knew that diabetes could be sight threatening [18]. The present study and the other were shown that there was significant direct association between people awareness rate and their education [19,20]. In this study and results of Yazd and Tehran study were observed 47.3%, 40.2% and 49% of people respectively got their awareness by means of community.
One of the most prevalent metabolic disease is diabetes and it can lead to enormous medical as well as socio-economic consequences.
The Iranian diabetes population is estimated to be around 1.5 million. Studies show that approximately half of the people with type 2 diabetes (T2DM) are undiagnosed and thus unaware that they have the disease. This lack of awareness can lead to presentation with complications and its consequences.
The aim of this survey was to determine the level of population awareness in Bushehr port, based on the available education programs.
The cross-sectional study was assessed upon 719 subjects aged over 18 years old, without diabetes and inhabitant in Bushehr port in 2005. Multi-stage random simple sampling was used in this study. A questionnaire was prepared with validity checked by researchers in Yazd Diabetes Research Center and reliability alpha-cronbach = 75%.
The questionnaire was included 39 questions: demographics indices, fundamentals about diabetes, its presenting signs and symptoms, the early and late complications, means of management as well as looked into the source of the information. The data was analyzed with independent t-test, Pearson's correlation coefficient, ANOVA and multiple-regression models by SPSS package ver. 10.05.
In this study, 719 subjects (417 male and 302 female) that mean age was 40.13 ± 11.48 years (40.8 ± 12.93 for male and 39.19 ± 9.03 for female) were assessed. The male awareness rate was more than of female (P = 0.001). There was indirect relation between subjects’ awareness and their age (r = −0.203, P = 0.001). There was direct relation between awareness and the level of education of subjects (P = 0.01, r = 0.07). The mean of awareness scores of subjects was not same between singles and married (P = 0.042). Studies population awareness about fundamental diabetes disease, primary symptoms, early complications, delay complications, diet awareness was low and about controlling methods of diabetes was high.
The results indicate that most subjects’ awareness about fundamental and complications of diabetes disease were low, so the people need more education about diabetes.
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Hypertension is a common medical disorder affecting >50 million people. It is a primary modifiable risk factor to cardiovascular disease and a leading cause of death in black and Hispanic groups. This article focuses on patient-specific and physician-specific barriers that contribute to underdiagnosis, undertreatment, access issues, and poor adherence to therapy. Two cross-cultural interviewing frameworks, ETHNIC and ADHERE, are discussed as approaches that complement the traditional clinical assessment and treatment of hypertension in Hispanics.
Fatalism and hypertension prevalence, awareness, treatment and control in US Hispanics/Latinos: results from HCHS/SOL Sociocultural Ancillary Study
2017, Journal of Behavioral Medicine

View all citing articles on Scopus

View full text

Awareness of hypertension and diabetes in the Hispanic community

Am J Prev Med

Ann Epidemiol

Am J Hypertens

Arch Phys Med Rehabil

Am Heart J

The Hispanic Population of the United States: March 2002

Sub-optimal outcomes of management of metabolic cardiovascular risk factors in Hispanic patients

Hypertension

The impact of ethnicity on response to antihypertensive therapy

Am J Med

Statistical Database C905JF3C1

Race-ethnic disparities in the impact of stroke factors: The Northern Manhattan Stroke Study

Stroke

Deaths of Hispanic origin, 15 reporters states 1979–1981 (National Center for Health Statistics)

Vital Health Stat

Hypertension in multicultural and minority populations: Linking communication to compliance

Curr Hypertens Rep

Hypertension in Hispanics. Comments on a major disease in a mix of ethnic groups

Am J Hypertens

Hypertension in minority populations: Access to care

Am J Med

Single-drug therapy for hypertension in men. A comparison of six antihypertensive agents with placebo

N Engl J Med

Lifetime risk for diabetes mellitus in the United States

JAMA

Trends in Causes of Death Among the Elderly. Aging Trends

Racial and ethnic differences in health insurance coverage for adults with diabetes

Diabetes Care