Hypertension and related health issues among Asians and Pacific Islanders in California.

The prevalence of controlled and uncontrolled hypertension in the United States is lower for persons ethnically classified as Asian, particularly Japanese and excepting Filipinos, than for the general population. In this study, measurements of blood pressure were taken of 8,353 adults living in California, including 1,757 Asians and Pacific Islanders, and the subjects were asked six questions concerning high blood pressure. The results show that Asians and Pacific Islanders with hypertension, in comparison with hypertensive persons of other races, were less likely to be aware of their hypertension, to be under treatment with medication, and to be controlling their blood pressure; similarly, they had their blood pressure measured less frequently and visited physicians less often. Compared with the general population, Asians and Pacific Islanders were less knowledgeable about hypertension. In relation to health care, they recorded lower frequencies of hospital stays, days of bed disabilities, and days of not feeling well than persons of other races. Asians and Pacific Islanders' lower treatment rates and knowledge level concerning hypertension may be related to the fact that a high percentage are foreign-born. Consequently, they have been taught less about hypertension, rely more on traditional methods of medicine, and are hampered by the lack of availability of health care providers of their own ethnic background. In addition, Filipinos have experienced high levels of poverty and lack of education. These factors require additional study as part of efforts to help improve health care for these ethnic groups in the United States.

Hypertension-related mortality in California.

Death rates in California for hypertension-related diseases during 1969-71 and 1979-81 are compared. During both periods, age-standardized rates for a composite hypertension-related mortality category are highest for blacks, followed by whites, and lowest for Asians and Pacific Islanders. Filipinos who have high prevalence rates of hypertension record low rates of hypertension-related mortality. After adjusting for the comparability ratio, the age-standardized hypertension-related death rate declined by more than 28 percent between 1969-71 and 1979-81. The decrease was greatest at age 15-44 years. Of all major hypertension-related diseases, cerebrovascular diseases registered consistently large percentage declines in mortality for all age and race groupings examined. Possible reasons for the considerable decline in hypertension-related mortality and low death rates for Asians and Pacific Islanders are discussed. The combined effects of improved population awareness, level of treatment, and control of hypertension; a greater knowledge of cardiovascular risk factors and associated modifications of behavior; and improved medical technology and care may have contributed to the decline.

Hypertension among Asians and Pacific islanders in California.

Hypertension is investigated among Asians and Pacific islanders in California. Descriptive rates are provided for four Asian and Pacific islander ethnic-sex-age subgroupings. Overall, Filipinos have rates of hypertension nearly equal to those of American blacks and, in some large demographic categories, have prevalence rates comparable to blacks. Uncontrolled hypertension is shown to be related to overall health levels measured by life expectancy, chronologic age, and relative body weight. Change in dietary patterns toward the adoption of American foods increases both relative body weight and the risk of hypertension. The adjusted rates of hypertension are similar for men and women after the effects of relative body weight, alcohol consumption, and other variables are removed. A psychologic dimension of variables, including excess alcohol intake and proneness to depression and boredom, increases prevalence of high blood pressure. Social support mechanisms such as marriage, religious affiliation, and a large number of friends are associated with lower levels of hypertension. Many predictor variables are analyzed along with reasons for the high prevalence rates of hypertension for Filipinos and low rates for Japanese.

Indices of relative body weight and ideal weight charts.

Established indices of relative body weight are reviewed and critically evaluated in terms of five criteria: (1) high correlation with obesity, (2) a conceptual interpretation, (3) universality, (4) simplicity of computation, and (5) zero correlation with height. Regression procedures are used to create standard weight charts which are distributed similarly to the body weight of 13,645 Americans, provided by the National Health Survey (NHS), and which have an arithmetic mean equal to the mean of the Metropolitan Life Insurance ( MLI ) table of desirable weights. A similar method is used to create a standard weight table based on body mass index (BMI). Finally, standard body weight charts which are uncorrelated with sex, age, and/or body frame are developed and discussed in terms of their usefulness.

California's approach to hypertension control: an overview.

California's Department of Health Services, recognizing the serious community health problem presented by uncontrolled hypertension, developed community-based programs of early detection and referral, follow-up and education. Special consideration was given to underserved populations at high risk. A statewide probability household survey was conducted and showed an improvement in control status during the past decade for definite and critical hypertension, but not for mild hypertension. With diminishing public resources, future efforts must be cost effective, focus on care for persons known to have hypertension and encourage maximum coordination between private and public agencies.

Alcohol use among college students: Some competing hypotheses.

This paper presents a longitudinal study of alcohol use among college students. Three hypothesized predictors of alcohol use are found to have an independent effect when the other predictors and prior drinking are held constant: the drinking context of the dormitory living group, informal social involvement in college, and lack of commitment to religious and academic values. These predictors are also related to the onset of drinking during the freshman year for those who entered college as abstainers. The pattern varies somewhat for males and females, with the dormitory contextual effect larger for females. Formal involvement in college activities and psychological stress have no independent effect on drinking. The results are discussed in relation to previous work on alcohol use.