Chronic disease prevention in Laredo, Texas.

The Laredo-Webb County Health Department began planning a health promotion program for the prevention of chronic diseases during the late 1970s. After receiving a 4-year grant from the W.K. Kellogg Foundation, the Department initiated the program in 1983 by conducting an epidemiologic survey in Laredo, Texas, to determine the major risk factors for chronic disease. A comprehensive health education program was then initiated to reduce the prevalence of these factors in targeted low-income neighborhoods. Health information was disseminated among the population in small neighborhood groups using a variety of techniques to promote favorable changes in health behavior. An evaluation of the program in one neighborhood 1 year later showed an overall reduction in health risk practices of approximately 10%.

Cardiovascular risk factors in Mexican Americans in Laredo, Texas. I. Prevalence of overweight and diabetes and distributions of serum lipids.

An epidemiologic survey of cardiovascular risk factors was carried out on a random sample of Mexican Americans living in two low income census tracts in Laredo, Texas. The prevalence of overweight was found to be intermediate between US national estimates and the rates recorded for Pima Indians. Similarly, the prevalence of fasting hyperglycemia was intermediate between the rates observed in a sample or predominantly Caucasian individuals and those observed in Pima Indians. Excess hyperglycemia in the Laredo Mexican American population compared to predominantly Caucasian populations does not appear to be due to a lower level of medical control of diabetes in the former. Rather, it probably reflects a true excess in the prevalence of diabetes. Serum cholesterol and triglyceride concentrations were also higher in Laredo Mexican Americans than in a Caucasian comparison population. Mexican Americans are of mixed European and native American ancestry. Native Americans have high rates of diabetes which could be on a genetic basis. The intermediate rates of hyperglycemia in Mexican Americans could thus have a genetic explanation. On the other hand, sociocultural determinants could be important since these are known to influence obesity which is a major precursor of diabetes.

Cardiovascular risk factors in Mexican Americans in Laredo, Texas. II. Prevalence and control of hypertension.

In recent years there has been a marked improvement in the level of hypertension control nationally in both blacks and whites. Information is still lacking, however, on the level of hypertension control in Mexican Americans. The authors carried out a cardiovascular risk factor survey on a random sample of Mexican Americans living in two low income census tracts in Laredo, Texas. The percentages of hypertensive women who had been previously diagnosed, were under treatment, and were "under control" compared favorably with national figures for blacks and whites. Corresponding percentages for men indicated that their level of diagnosis, treatment and "control" still lagged behind the national figures. The prevalence of hypertension in Laredo Project participants was intermediate between those observed in national studies for blacks and whites. This finding did not clearly emerge when comparisons were based on either blood pressure distributions or prevalence of elevated diastolic pressures. These results indicate that, because of the increasing number of "controlled" hypertensives in the population, comparisons between populations and across time can no longer be based exclusively on blood pressure measurements, but must include cases of "controlled" hypertension.