michigan hypertension core curriculum - State of Michigan

appear to be related to access to care and adherence to anti-hypertensive mediations. The most
striking example of a Hispanic sub-population with limited access to health care is the undocumented
Hispanic population, which may number as many as 12 million. In addition, like many Americans,
Hispanics also may be underinsured. Both young and elderly Hispanics appear less likely to take
anti-hypertensive medications than both NHW and African-Americans. 5, 6 The reasons for this seem
to relate primarily to education about HTN and access to treatment. Diet is a major contributor to
HTN and dietary changes that are inconsistent with cultural norms may be difficult for some patients. 7
Interestingly, although there is clearly excess obesity among Hispanics, 8 which along with diet seem to
contribute to an excess prevalence of DM, there appears to be a less than expected effect on the risk
for HTN.
Treatment
There is little data to support the idea that Hispanics BP is any more difficult to control than
in non-Hispanic Whites. Much of the challenge in treatment relates to improving awareness of and
education about HTN. The goals and approach to HTN management in Hispanics is generally similar
to other racial and ethnic groups. At the same time, attention of course needs to be paid to issues of
culturally competent care and the need to recognize patients for whom a Spanish-speaking provider
would be a particular asset. There should be recognition that there are a number of different Hispanic
sub-populations, cultural norms and risk factors across the larger Hispanic population. Hispanic
patients should have BP goals established consistent with JNC-7 recommendations and their other
medical co-morbidities and therapeutic lifestyle change should be encouraged.
Figures:
Figure 1-2, figures 1 and 2 from the CDC MMWR Feb 24, 2006/55(07); 177-180
Essential points check:
1. Hypertension prevalence in Hispanics is similar to that in NHW.
2. Improved HTN control in Hispanics requires efforts to improve awareness of HTN in the
community.
3. The goals for HTN treatment are the same as in NHW.
Post-Test Questions:
1. The prevalence of HTN is very similar among Hispanic sub-populations in the U.S.
a. True
b. False (Correct answer)
c.
2. Compared to non-Hispanic Whites, the risk for HTN in Hispanics can be related to which of the
following?
84 Hypertension Core Curriculum