Lurking in plain sight: Hypertension awareness and treatment among New York City taxi/for‐hire vehicle drivers

Abstract

Uncontrolled hypertension may be worse for certain occupational groups, including taxi and for-hire vehicle (FHV) drivers. In 2015, one in three US adults had hypertension, 1 based on hypertensive values at systolic blood pressure (SBP) >140 mm Hg and/or diastolic blood pressure (DBP) 90 mm Hg. 2 Approximately, 50% (35 million) of those with hypertension had uncontrolled hypertension. 1 The 2017 American College of Cardiologists/American Heart Association guidelines lowered the hypertensive-range values such that hypertensive-range blood pressure (BP) starts at SBP 130 mm Hg or DBP 80 mm Hg; the prehypertensive range is now SBP 120-129 mm Hg and DBP <80 mm Hg. 3,4 Hypertension is a major risk factor for stroke, coronary artery disease, and renal failure, among other conditions. 5 The Centers for Disease Control and Prevention (CDC) estimate that 33% of people with uncontrolled hypertension may be unaware of their condition. 1 In one study, 20% of participants self-reported hypertension yet biometric measurements revealed 35% of all participants had hypertensive values. 6

Systematic Review and Meta-Analysis of Metabolic Syndrome and Its Components in Latino Immigrants to the USA

“…Of these publications, 12 stratified length of residence into <10 years and >10 years [26,28,32,34,35,38,39,42,58,70,78,81]. The other studies included immigrants with <10 years of residence in the USA [30,65], <15 and >15 years [29,44,53,54,56], <20 and >20 years [41,50,66,74,80], or <25 and >25 years of residence [14]. Eleven studies [16,40,47,51,52,55,61,64,67,75,77] reported only average years of residence.…”

“…Immigrant-Related Health-, Dietary-, and Lifestyle-Related Community-Related generational status [14] nativity [26,35,42,54,72] health behaviors [16,34] immigrant concentration [49,68] length of residence in USA [14,26,36,39,47,72,81] agricultural work [31,33,61] health assimilation; health literacy; nutrition transition; dietary characteristics [41,47,51,80] community factors [58,68] migration history [34] income; sociodemographic factors [31,32,47,53,68,70] healthcare services access and utilization [56,62] immigration [15,[27][28][29][30][31]45,82] ethnicity [37,44] food insecurity [64,65] acculturation …”

“…In total, 17 articles analyzed work-related factors [16,31,33,39,41,43,44,46,47,53,55,61,64,[66][67][68],70] and 9 described participant occupations, of which 4 involved rural or agricultural workers [31,33,61,70], 2 taxi/for-hire vehicle drivers, 1 professional/management and support services workers [44], and 1 female homemakers and others [66], while 1 encompassed a broad group of workers [16], dividing participants into: skilled professional, semiskilled white-collar, clerical, semiskilled blue-collar, unskilled service, laborer, or farmworker; homemaker; and unemployed or student. Four studies addressed the issue of immigrant documentation in their results [43,46,61,76] and 19 included information on holding health insurance or otherwise [28,31,33,36,37,39,40,45,46,49,[54][55][56][57]63,68,75,78,…”

“…Of the studies included in the meta-analysis, 23 were heterogeneous (Figure 2). Within this group, some studies [16,39,50,53,68,70,78,82] differed more with respect to population size, measurement approach (objective or subjective), design (one case-control study) and characteristics of the population (ethnicity, age, and country of origin).…”

Body mass index mediates the direct association of subjective social status and hypertension in a fulani west African immigrant sample.

“…High rates among African immigrants are thought to be the result of high carbohydrate and high sodium diets brought from home countries to sedentary host country environments. In one study, 80% of African immigrants employed driving taxi and for-hire vehicles in New York had hypertensive-range blood pressure readings (Narang et al, 2020). Secondary analysis of data on African immigrants in the National Health Institute Survey suggests that sedentarism, food insecurity, and length of residence are all important predictors of HTN in this population (Ojih & Bradford, 2022).…”