The association of language with prevalence of undiagnosed hypertension among older Mexican Americans.

OBJECTIVE: Language barriers have been shown to negatively impact health care for immigrants. We evaluated the association between language use and the diagnosis of hypertension among elderly Mexican Americans. STUDY POPULATION: We studied subjects from the Hispanic Established Populations for Epidemiologic Studies of the Elderly, a cohort of 3050 Mexican American subjects age > or =65. PREDICTORS: Measures of language included Spanish and/or English language read/spoken, language used in social situations, and language of mass media use. OUTCOME MEASURE: Undiagnosed hypertension on physical exam was defined as systolic blood pressure > or =140 mm Hg and/or diastolic blood pressure > or =90 mm Hg in persons who did not report previous hypertension diagnosis or were not current users of anti-hypertensive medications. RESULTS: The age- and sex-adjusted prevalence of diagnosed hypertension and undiagnosed hypertension were 50.5% and 19.3%, respectively. Among 1347 older adults without previous diagnosis of hypertension that were included in the primary analysis, the mean age was 72 years and 43% were immigrants. After adjusting for age, gender, and education, Spanish use more often than English use in mass media was significantly associated with undiagnosed hypertension (adjusted OR 2.2 [1.3-3.6]). Other measures of acculturation were not independently associated with undiagnosed hypertension. In analyses restricted to persons with hypertension, similar language factors distinguished those who had been diagnosed from those whose hypertension was undiagnosed. CONCLUSIONS: Mexican American elders who reported using Spanish more often than English use in mass media were more likely to have undiagnosed hypertension compared to those using English language in mass media. Further studies are needed to elucidate the role of mass media language in hypertension awareness and management among Hispanic elders.