Prevalence of undiagnosed hypertension among Samoan and Tongan adults in California

Background/Significance: Hypertension is a particularly deadly disease because of the large number of people who are unaware that they are at risk for it or have it. It is estimated that almost one-third of hypertensive people are unaware and so do not seek intervention early, when the disease is most treatable. This problem represents a particular concern among Pacific Islanders (PI) in the US due to high rates of obesity combined with language barriers, limited insurance and poverty that often result in low levels of preventative care.

Objective/Purpose: As the only way to know if an individual has hypertension is through regular checkups and monitoring changes in measured blood pressure readings, we argue that the reported cases of known hypertension among the PI sample may significantly underreport the actual prevalence in the community. We test this assumption using data from the 2012 Pacific Islander Health Study, a representative survey of health behaviors and health condition etc. among Samoan and Tongan in California.

Methods: The PIHS measured hypertension using two mechanism. Baseline levels of hypertension were obtained by asking the respondent if they had ever been diagnosed with high blood pressure. In addition to self-reported health outcomes, the survey team also obtained resting blood pressure readings at two intervals during the interview from all consenting respondents.

Results: The findings show high levels of hypertensive blood pressure readings among those reporting no history of hypertension 30 percent had BP readings suggestive of high blood pressure. Almost half of the sample showed at least pre-hypertensive readings reflecting the high risk of undiagnosed hypertension in this population.

Discussion/Conclusions: These results show striking evidence for the potential of significant levels of undiagnosed hypertension in the PI community. These results provide essential information for health care advocates and care givers in NHPI communities.