Hypertension Prevalence, Treatment, and Related Behaviors Among Asian Americans: An Examination by Method of Measurement and Disaggregated Subgroups
Data on hypertension among Asian Americans is lacking and often aggregated, which can mask important ethnic differences. This study aims to provide a comprehensive view of hypertension and hypertension-related behaviors, including hypertension treatment, management, and information seeking, among Chinese, Korean, and Vietnamese Americans.
Data were collected from 600 foreign-born Asian Americans (201 Chinese, 198 Korean, and 201 Vietnamese participants) in the Washington–Baltimore metropolitan area, aged 18 years and over, from 2013 to 2014. Hypertension was assessed using direct measurement and self-report of having ever been told by a physician. Hypertension prevalence was compared based on the method of assessment, ethnicity, and sex.
The age-adjusted hypertension prevalence from direct measurement was 27.5%, which is higher than the 2011–2014 National Health and Nutrition Examination Survey estimate for Asians (24.9%). Hypertension prevalences from self-report among Chinese, Korean, and Vietnamese were 13.4%, 23.2%, and 22.9%, respectively, which are lower than 2014 California Health Interview Survey estimates (15.6%, 18.4%, and 25.8%) with the exception of Korean participants. In regard to hypertension-related behaviors, 67.8% of hypertensive adults received management, 64.3% took antihypertensive medication, and 67.0% sought information to improve their hypertension.
Disaggregated data on hypertension based on measured blood pressure may prevent underestimation from self-report, particularly among those with limited healthcare access. More accurate and objective assessment of hypertension is needed for improved monitoring of hypertension among Asian-American subgroups.
KeywordsAsian Americans Hypertension Prevalence Disease management Information-seeking behavior
MSC codes62P25 (Statistics—applications to social sciences) 97F80 (Ratio and proportion, percentages)
This study was supported by the National Cancer Institute (R01CA163805)..
This study was supported by the National Cancer Institute (R01CA163805).
Compliance with Ethical Standards
Conflicts of Interest
The authors have no conflicts of interest to declare.
All procedures performed involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants in the study.
- 1.Hoeffel EM, Rastogi S, Kim MO, Hasan S. The Asian population: 2010. In: 2010 U.S. Census Briefs. U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau. 2012. https://www.census.gov/prod/cen2010/briefs/c2010br-11.pdf. Accessed December 14 2017.
- 3.Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics—2016 update: a report from the American Heart Association. Circulation. 2016;133(4):e38–e360.Google Scholar
- 4.Yoon SS, Fryar CD, Carroll MD. Hypertension prevalence and control among adults: United States, 2011-2014. NCHS Data Brief. 2015;(220):1–8.Google Scholar
- 12.Kim MT, Kim KB, Juon HS, Hill MN. Prevalence and factors associated with high blood pressure in Korean Americans. Ethn Dis. 2000;10(3):364–74.Google Scholar
- 16.Smith SC, Clark LT, Cooper RS, Daniels SR, Kumanyika SK, Ofili E, et al. Discovering the full spectrum of cardiovascular disease minority health summit 2003: report of the obesity, metabolic syndrome, and hypertension writing group. Circulation. 2005;111(10):e134–e9.Google Scholar
- 17.Nwankwo T, Yoon SS, Burt V, Gu Q. Hypertension among adults in the United States: National Health and Nutrition Examination Survey, 2011-2012. NCHS Data Brief. 2013;(133):1-8.Google Scholar
- 18.Barnes PM, Adams PF, Powell-Griner E. Health characteristics of the Asian adult population: United States, 2004-2006. Adv Data. 2008;(394):1-22Google Scholar
- 19.Han H-R, Kim KB, Kang J, Jeong S, Kim E-Y, Kim MT. Knowledge, beliefs, and behaviors about hypertension control among middle-aged Korean Americans with hypertension. J Community Health. 2007;32(5):324–42.Google Scholar
- 20.Devers K, Gray B, Ramos C, Shah A, Blavin F, Waidmann T. The feasibility of using electronic health records (EHRs) and other electronic health data for research on small populations. The Urban Institute Health Policy Center, Washington, DC. 2013. https://aspe.hhs.gov/report/feasibility-using-electronic-health-data-research-small-populations. Accessed December 14 2016.
- 22.Centers for Disease Control and Prevention/National Center for Health Statistics. 2015 National Health Interview Survey Questionnaire—Sample Adult. Hyattsville, Maryland: U.S. Department of Health and Human Services; 2016. ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Survey_Questionnaires/NHIS/2015/english/qadult.pdf. Accessed 12 December 2018.
- 23.Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System 2015 codebook report land-line and cell-phone data. Atlanta, Georgia: U.S. Department of Health and Human Services; 2016. https://www.cdc.gov/brfss/annual_data/2017/pdf/codebook17_llcp-v2-508.pdf. Accessed 12 December 2018.
- 24.National Center for Chronic Disease Prevention and Health Promotion. Division of Population Health. BRFSS frequently asked questions (FAQs). U.S. Department of Health & Human Services, Atlanta, GA; 2015. http://www.cdc.gov/brfss/about/brfss_faq.htm. Accessed December 14 2017.
- 25.California Health Interview Survey. CHIS 2014 adult survey public use file. [computer file]. Los Angeles, CA: UCLA Center for Health Policy Research; July 2017. http://healthpolicy.ucla.edu/chis/data/Pages/public-use-data.aspx. Accessed 12 December 2018.
- 26.UCLA Center for Health Policy Research. CHIS methods to accurately represent California’s diverse population. In: CHIS Data Quality. 2012. http://healthpolicy.ucla.edu/chis/design/Pages/data-quality7.aspx. Accessed August 26 2016.
- 27.Centers for Disease Control and Prevention/National Center for Health Statistics. NHANES 2011–2012 questionnaire data overview: questionnaire and interview languages. U.S. Department of Health & Human Services, Atlanta, GA. 2014. https://wwwn.cdc.gov/nchs/nhanes/ContinuousNhanes/OverviewQuex.aspx?BeginYear=2011. Accessed 12 December 2018.
- 29.Daskalopoulou SS, Rabi DM, Zarnke KB, Dasgupta K, Nerenberg K, Cloutier L, et al. The 2015 Canadian hypertension education program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Can J Cardiol. 2015;31(5):549–68.CrossRefGoogle Scholar
- 31.National Heart Lung, and Blood Institute. What is hypotension? National Institutes of Health, Bethesda, MD. 2010. https://www.nhlbi.nih.gov/health/health-topics/topics/hyp. Accessed July 15 2017.
- 37.Pham TM, Rosenthal MP, Diamond JJ. Hypertension, cardiovascular disease, and health care dilemmas in the Philadelphia Vietnamese community. Fam Med. 1999;31:647–51.Google Scholar
- 41.Ma GX, Lee M, Bhimla A, Tan Y, Gadegbeku CA, Yeh MC et al. Risk assessment and prevention of hypertension in Filipino Americans. J Community Health. 2017;42(4):797-805.Google Scholar