Hypertension in Hispanics

Demographic projections predict that Hispanics will be the largest minority group in the United States by the year 2000. The term “Hispanic”, however, encompasses a mix of national and ethnic origins, that for the most part includes peoples from Mexican, Puerto Rican, Central and South American, and Cuban descent. Not surprisingly, differences in the incidence and causes of cardiovascular mortality exist not only between Hispanics, non-Hispanic whites and African-Americans, but also among Hispanics. As in all other groups, hypertension is also a major factor in Hispanic cardiovascular morbidity and mortality. Yet, despite the growth of our knowledge of hypertension in Hispanics in the past decade, there are still enormous gaps that must be overcome. Questions about access to health care and use of health facilities by Hispanics, even when these are available, complicate the detection, treatment and control of high blood pressure. As a consequence it is possible that in some sub-groups outcomes from the disease are more somber than in non-Hispanic whites. On the other hand, it is of interest that in some studies the prevalence of hypertension in Hispanics (Mexican-American) is intermediate between non-Hispanic whites and African-Americans. The prevalence of hypertension may be higher in Hispanic (Mexican-American) women than in non-Hispanic white females. Prior to 1950, there was less prevalence of hypertension and of coronary artery disease in Puerto Rico than in mainland Puerto Ricans. Recent studies in Puerto Rico have shown that the prevalence of hypertension parallels that of Mexican-Americans in the mainland. The possibility that dietary factors, obesity and stress play a role in this change deserves further study. These issues will be discussed further.