Awareness about factors that affect the management of hypertension in Puerto Rican patients.

INTRODUCTION: There are few published reports describing the health status of Hispanic populations in the United States with chronic illnesses, such as hypertension. Most studies on hypertension in Hispanics are on Mexican-Americans and little data exist for other Hispanic subgroups, such as Puerto Ricans. Health-related issues specific to a particular Hispanic subgroup may not be generalizable to all Hispanics. Patients' perceptions and awareness of health-related issues specific to a particular medical condition play an important role in the management and outcome.

OBJECTIVE: The primary objective of the study is to determine if patients' general perceptions of hypertension, hypertension-related risk factors, complications, and life-style behavior modifications correlated with various patient demographics, such as age, gender, primary language, education level, socioeconomic status, marital status, health insurance category, and employment status. The working hypothesis is that patients who are older, unmarried, less educated, Spanish-speaking only, unemployed, and have low income, are more likely to report lack of awareness to various hypertension-related issues.

SETTING: Hospital-based ambulatory center with major emphasis on providing care to underserved populations of the surrounding community, of which Puerto Ricans comprised the predominant ethnic group.

STUDY DESIGN: A single, bilingual interviewer administered a series of questions to Hispanic, hypertensive patients. Questions were divided into the following seven categories: patient knowledge and perception of the disease; diet and salt intake; tobacco use; alcohol use; weight control and exercise; and medication and alternative therapy use. Within each category were various questions designed to study the patients' knowledge of hypertension, self-reported compliance with behavior modifications, and patient education on these behaviors. Data from 19 Puerto Rican patients were collected and chi-square tests and pothoc power analyses were performed. Responses to the various questions were correlated to patient demographics and socioeconomic variables.

RESULTS: Use of herbal teas correlated significantly with the patients' primary language. Twenty-one percent of the patients who spoke Spanish only used herbal teas for treatment of their hypertension. All patients who reported herbal medication or tea use had a middle school education. There were many trends towards statistical significance in the following categories: patient perceptions and level of formal education; patient knowledge of hypertension and language spoken; salt intake and years of schooling; and correlation of herbal use with employment status, health insurance statu, and age.

CONCLUSION: Additional research must be undertaken with larger sample sizes to give validity and statistical significance to the observed findings. This study and previous research, demonstrate some of the special issues that may need to be considered in the delivery of health care to specific Hispanic patient populations.