Factors influencing unawareness of hypertension among older Mexican Americans

Background. The objective of the study was to identify factors associated with unawareness of hypertension among Mexican Americans age 65 years and older. Methods. This was a population-based survey of 3,050 older Mexican Americans conducted in five Southwestern states in 1993-1994. An in- home interview included sociodemographics, review of medications, and blood pressure measurements. Results. Sixty percent of all subjects were hypertensive, and 37% of these were unaware of their diagnosis. Unaware hypertensives had significantly higher mean blood pressures than did aware hypertensives (145.7/86.2 mm Hg vs 142.4/83.1 mm Hg). While 77% of aware hypertensives were treated, only 10% of unaware hypertensives were treated. In multivariate analyses, factors associated with unawareness included male gender (OR = 1.8), being married (OR = 1.6), having Medicaid (OR = 1.6), having made fewer than two visits to a doctor in the past year (OR = 2.8), having a history of heart disease (OR = 0.57) or stroke (OR = 0.37), and having poor self-reported health (OR = 0.43). Conclusion. Despite 3 decades of hypertension detection and education programs, unawareness of hypertension remains high among older Mexican Americans. There is a continued need for community-based education programs for hypertensives who are unaware of their diagnosis, and also there is need for programs to increase access to primary care physicians.