Hypertension in Hispanic Populations: Your Guide to High Blood Pressure

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High blood pressure (hypertension) ranks pretty high on the list of health problems that affect adults in the U.S. Almost half of adults in the U.S. have hypertension. That's about 120 million people. And having high blood pressure raises your risk of heart disease and stroke, two leading causes of death in the U.S.

Rates of hypertension in the Hispanic population are pretty similar. That means more than 30 million Hispanics and Latinos have hypertension. But Latinos are less likely to be insured and get treatment for high blood pressure. Let's take a closer look at what you can do to lower your risk.

What is hypertension (high blood pressure)?

High blood pressure (hypertension) is when the force of the blood pushing against your artery walls is too high. This increased force isn't something that you can feel. This is why high blood pressure is often called a "silent killer" - usually there are no symptoms.

So measuring your blood pressure is usually the only way to know for sure if it's high. You cancheck your blood pressure at home, or a healthcare professional can check it for you.

A lot of things can temporarily change your blood pressure, including stress, caffeine, smoking - even talking. So, before getting a diagnosis of high blood pressure, you'll need two or more measurements, and on different days.

A "normal" blood pressure reading is 120/80 mmHg or less. The first, or top number, is your systolic pressure. The second, or bottom number, is your diastolic pressure. You may have hypertension if your systolic is over 130 or your diastolic is over 80.

How prevalent is hypertension in the Hispanic community?

About 62 million Hispanics and Latinos live in the U.S., which is almost 19% of the total population. There's a lot of diversity in the broad terms "Latino and Hispanic." This includes people from Mexico, Central America, the Caribbean, and South America. But many research studies have failed to account for differences in race, culture, history of immigration, socioeconomic status, and culture.

On the whole, rates of hypertension in the Hispanic population are similar to those of the non-Hispanic white population in the U.S. Nearly 5 in 10 Latino adults have high blood pressure. But the rates appear to vary quite a bit across these different communities. One study found that people from Caribbean backgrounds - Cuban, Puerto Rican, and Dominican - were more likely than Mexican Americans to have high blood pressure.

The rates of high blood pressure are much higher among Black people than other groups in the U.S. Researchers aren't exactly sure why this is the case. There may be a genetic link. It isn't totally clear how this may apply to other Black communities, such as Afro Latinos with cultural roots in the Caribbean and Latin America.

Some research suggests that Afro Latinos may have a higher risk of hypertension and diabetes than white Hispanics. But more research is needed to better understand the unique health risk of this large population. An estimated 6 million adults in the U.S. identify as Afro Latino.

What risk factors contribute to hypertension among Hispanics?

Lots of different things can increase your risk of developing high blood pressure. Some of these apply to everyone, and there's not much you can do to change the risk. High blood pressure runs in families and is more common among men and older adults.

The environment you live in also affects your health in many ways. Latinos are more likely to experience poverty and are 2.5 times as likely to be uninsured than the general population - both of which are associated with a higher risk of developing high blood pressure. There's also evidence that living in the U.S. raises your risk for developing high blood pressure. So, the longer an immigrant lives in the U.S., the more their risk for high blood pressure goes up.

Hispanics and Latinos are also more likely to develop diabetes. Although Mexicans have the highest risk, on average, all Latinos are twice as likely to develop diabetes than non-Hispanic whites. And people with diabetes are twice as likely to develop high blood pressure than those who don't have diabetes.

The good news is that, no matter your background, there are lots of things that you can do to lower your risk of developing high blood pressure.

How do you treat hypertension?

For many people, the first step toward treating high blood pressure is getting their blood pressure checked. Finding out that your blood pressure is high can be scary, but getting a diagnosis opens up a door to treatment.

Treatment can take a lot of forms and depends on how severe your high blood pressure is and other health conditions you may have, like diabetes. For some, lifestyle changes are enough. Many people will also need medications to help manage their blood pressure.

Remember that everyone has a right to access medical care in the U.S. - no matter your insurance or immigration status.

Lifestyle changes

To prevent high blood pressure or to help manage an existing diagnosis, there are lots of things that you can do to lower your risk:

• Stop smoking, or don't start. Using tobacco increases your blood pressure in the short term, and it can lead to artery damage over the long term. There's help to quit smoking.

• Be physically active. Regular physical activity is a great way to lower your risk for heart-related conditions. Exercises to lower blood pressure include aerobics, strength training, and mind-body practices like yoga. Aim to get 150 minutes of moderate-intensity aerobic activity a week.

• Manage your stress. Lots of things can make you feel stressed, and stress can lead to many different health issues, including high blood pressure. There are proven ways to lower your stress, like learning your triggers and getting quality sleep.

• Eat a balanced diet. Following a balanced diet is good for your overall health, and there are lots of ways to do this while eating meals rooted in Latin American culinary traditions. Staples like avocado, beans, and peppers are great for heart health. Some foods and drinks can even help lower your blood pressure.

• Limit your salt. Most people consume too much salt, and that increases your risk for high blood pressure as well as strokes and cardiovascular disease. There are many salt alternatives that can add flavor to your favorite dishes without putting your heart at risk.

• Maintain a comfortable weight for you.Extra weight strains your heart. Your healthcare team can help you figure out a weight that works for you.

• Avoid or limit alcohol. People who regularly drink alcohol are at a higher risk of hypertension.

Medications for high blood pressure

When lifestyle changes aren't enough to lower your blood pressure, your healthcare team can recommend medication. There are lots of options when it comes to medications for high blood pressure.

Here are the four main types that are usually used first:

• Thiazide diuretics ("water pills")

• Calcium channel blockers

• Angiotensin-converting enzyme (ACE) inhibitors

• Angiotensin II receptor blockers (ARBs)

Other types of medication that can be used to treat high blood pressure include:

• Beta blockers

• Alpha blockers

• Other types of diuretics

Keep in mind that some people take more than one blood pressure medication.

Challenges in treating high blood pressure among Latinos

Among all racial and ethnic groups in the U.S., Hispanics and Latinos are the most likely to be uninsured. In 2020, over 18% of the Hispanic population had no health insurance coverage, whereas about 5% of non-Hispanic whites had no coverage.

And research shows that people who are uninsured or underinsured are less likely to get care. That means that the rates of hypertension among Latinos are likely even higher than the data suggests. Unequal access to care creates serious challenges for both diagnosis and treatment.

A large study compared rates of high blood pressure awareness, treatment, and management among Latinos and the general U.S. population. It found that Latinos were less likely to be aware that they had hypertension, receive treatment, and actively manage the condition. The rates were lowest among Latinos without health insurance.

Beyond a lack of insurance, the reasons for these disparities aren't totally clear. But, in general, common reasons people don't take prescribed medications include medication costs and a lack of access.

Language and culture may also come into play. Research shows that when a healthcare professional speaks your language, you're more likely to go to follow-up appointments and fill your prescriptions.

Almost 6 in 10 Latinos say that they prefer to work with a healthcare professional who speaks Spanish. And that can be difficult. In the U.S., Hispanics make up only 9% of all healthcare professionals and technicians (and not all speak Spanish). And only 2% of non-Hispanic physicians speak Spanish.

Good to know: All healthcare programs that receive federal funding are required to provide free translation and interpretation services to people who need it. So make sure to ask for an interpreter if you feel more comfortable communicating in a language other than English.

Community resources for managing hypertension

Most of the lifestyle changes that can help lower your risk of developing high blood pressure are free. But costs of medical appointments and medications can add up - even if you have insurance.

There are low-cost and free options for people who are underinsured or uninsured. Here are some resources to help you access the care you need:

• Federally qualified health centers (FQHCs): FQHCs provide preventive and primary care services for free or at a sliding scale. Many also provide free blood work and other tests. They can't ask about your immigration status. Find an FQHC near you.

• Medication savings programs: Programs like GoodRx can help you find low-cost and generic medications. In 2023, people who used GoodRx saved an average of over 80% on retail prices for prescription medications. And you don't need insurance.

• Patient assistance programs: The goal of patient assistance programs is to help people with partial or no insurance afford their medications. But you must be a citizen or permanent or legal resident of the U.S. or Puerto Rico.

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