Correlates of Undiagnosed Hypertension Among Chinese and Korean American Immigrants

Abstract

Asian Americans are more likely to be unaware that they have hypertension compared to non-Hispanic white Americans, despite having higher risk of hypertension at lower body-mass indices. Furthermore, immigrants are more likely than their United States (U.S.)-born counterparts to have undiagnosed hypertension, placing them at greater risk of subsequent morbidity and mortality. This study examines the social determinants of undiagnosed hypertension among Asian American immigrants. Using a study of foreign-born Chinese and Korean Americans between the ages of 50–75 years-old recruited from physicians’ clinics in the Baltimore-Washington DC Metropolitan Area (n = 355), we used blood pressure readings measured by trained staff members, self-reported diagnosis by a medical professional, and self-reported hypertension medication use to determine hypertension status—whether patients were non-hypertensive, had diagnosed hypertension, or had undiagnosed hypertension. Using multinomial logistic regression, we examined how demographic, socioeconomic, and immigration-related factors were associated with hypertension status. Results indicated that older age, male gender, Korean subgroup, and marital status were associated with having diagnosed hypertension compared to being non-hypertensive. Lack of health insurance was the strongest predictor of having undiagnosed hypertension compared to being non-hypertensive. Acculturation variables had no strong associations with hypertension status. We then explored correlates of health insurance status for Chinese and Korean American immigrants. Those without health insurance were more likely to have lower income and to be not currently employed. Our findings point to the importance of increasing health insurance access for Asian American immigrant groups to ensure that hypertension is not left undiagnosed and untreated.

Undiagnosed hypertension and associated factors among adults in ethiopia: a systematic review and meta-analysis

“…The current systematic review and meta-analysis revealed that the pooled prevalence of undiagnosed hypertension in Ethiopia was 18.26% (95% CI 14.94, 21.58). This finding is comparable with those studies conducted on rural Ruanda18.7% [ 34 ], Chinese and Korean American immigrants (14.5%) [ 35 ], and United Kingdom patients (17%) [ 36 ]. This finding implies that strengthening the identification rate for undiagnosed hypertension is required.…”

“…The pooled odds of developing undiagnosed hypertension were approximately four times higher among the older adults than among the younger study participants. This finding is supported by studies of Chinese and Korean American Immigrants [ 35 ], Bangladesh [ 19 ], the Central Africa Republic [ 40 ], Nigeria [ 39 ] and Sudan national survey . [ 41 ] This is explained by the fact that as people agedthey are more likely to develop chronic illnesses such as hypertension.…”

Management of Hypertension in the Asia-Pacific Region: A Structured Review

“…Emigration studies may provide some insight into genetic versus environmental determinants of hypertension within an ethnic group. However, studies of Asian people emigrating to the USA have noted that access to healthcare and insurance status are the most important determinants of BP diagnosis and control [ 10 , 12 ].…”

Multi‐ethnic variation in the ties that bind rumination and heart rate variability: Implications for health disparities

“…Among Asian Americans, although the research is minimal, growing evidence suggests higher rates of car diovascular disease relative to their European American counterparts (Jose et al, 2014). To highlight the scarcity of this literature, to our knowledge only one recent study demonstrated that Asian Americans have increased risk for undiagnosed hypertension as compared to their European American counterparts (Morey et al, 2022). It may be that the prevalence of cardiovascular disease in this population is underdiagnosed (Narayan et al, 2010) and therefore warrants further study.…”