Unequal Burden of Diabetes and Hypertension in the Adult Population of the San Juan Metropolitan Area of Puerto Rico

Objective: The study describes critical information gaps regarding diabetes, hypertension, prediabetes, prehypertension and its comorbidities in a representative sample of the Hispanic adult population living in Puerto Rico. Research design and methods: A representative sample of non-institutionalized Puerto Ricans adults aged 18-79 years residing in the San Juan metropolitan area participated in a face-to-face interview, anthropometric measurements and blood draws. Prevalence of diabetes, hypertension, prediabetes, and prehypertension were estimated using logistic regression. Levels of awareness, treatment, adherence to medications, and control of these conditions were assessed. Results: Of 452 participants, 15.2% had diabetes, 35.3% had pre-diabetes, 39.9% had hypertension and 44.9% had pre-hypertension. Females were more likely to have diabetes, except those aged 18-64 years. Prevalence of diabetes, pre-diabetes, hypertension and pre-hypertension increased significantly with age in both sexes. Pre-hypertension was more prevalent among males in all age groups. Only 35% of those diagnosed with diabetes and 52.5% of those diagnosed with hypertension were controlled on pharmacotherapy. Conclusions: There is an unequal burden of diabetes, pre-diabetes, hypertension and pre-hypertension in Puerto Rico. The prevalence is high, increased significantly with age, and although the vast majority of participants with diabetes and hypertension were under treatment, control rates are suboptimal. These findings underscore the need for continued physician's efforts to improve control rates in our population.