High smartphone usage sets Latinos up for success to manage their blood pressure using apps

Recent surveys have revealed two important facts about the U.S. Hispanic population:

  1. Latino smartphone usage is higher than non-Hispanics.
  2. Latinos are at high risk for hypertension.

These two facts combine to create a unique opportunity for Latinos to reduce heart risk  by managing their blood pressure using blood pressure tracking and management apps (iOS, Android) on their smartphone.Let's take a look at some of  the risk factors and cultural trends to understand the why and how.

Hispanics are Ahead of the Curve in Adopting Smartphones

As of 2014, 77% of Latinos in the U.S. used smartphones. Not only is smartphone ownership high among Latinos, it is often their sole method of connecting online.

Latinos are ahead of the curve in adopting smartphones

Latinos at Higher Risk for Hypertension

The U.S. Hispanic population is expected to grow 188% between 2000 and 2050, making it the fastest growing ethnic minority population in the country. A large majority of this population is Mexican American.High blood pressure is on the rise for both Mexican-Americans and non-Hispanic whites, but awareness and treatment levels for Mexican-Americans are lower. Growing particularly quickly is the number of older Mexican Americans with high blood pressure. It is this group that is mostly likely to suffer from hypertension-related complications.

older latinos are especially at risk for hypertension

What are the Hypertension Numbers for Latinos?

Surveys have shown that Mexican Americans experience less blood pressure treatment and control than non-Hispanic whites. With this in mind, it is not surprising to find that over 30% of Mexican American men and almost 29% of Mexican American women have high blood pressure.Additionally, among Hispanics who experienced a stroke, 72% had high blood pressure, compared to 66% in non-Hispanic whites.

High blood pressure heart risk for Latinos

But hypertension is not the only health threat. Latinos face additional challenges that affect heart risk.

Additional Risk Factors Increase Threat To Latino Heart Health

High Levels of Uninsured

While minorities have gained health insurance at higher rates than white Americans since the marketplaces created by the Obamacare health care law opened, still almost 30% of Latino are uninsured (down from 40%). That leaves them as the country's largest uninsured minority.Hispanic adults are less likely to have employer-sponsored insurance. Moreover people who are in the country illegally are not eligible to buy insurance through marketplace plans.  Mexican Americans, for example,  are highly uninsured, with 49% of foreign-born Mexican Americans and 21% of U.S. born Mexican Americans uninsured. This makes them less likely to receive preventative treatment.

High Rate of Uninsured Latinos

The same study reported that a third of immigrant respondents said cost was the most salient issue and more than a fourth struggled to afford doctor, hospital, and prescription costs. Among those with hypertension, it was reported that 71% of younger Mexican American adults are untreated.

Excess Body Fat Around the Waist

80% of Mexican-American men and 76% of women age 20 and older are likely to have excess body fat around the waist. (Waist circumference of 40 inches or above in men, and 35 inches or above in women).  Among hypertensive Mexican American adults, the amount of belly fat is even higher.This is partly due to economic influences, limiting access to healthy foods. Latino neighborhoods have one-third the number of supermarkets as non-Latino neighborhoods.  Less healthy items (calorie-dense, low in fiber and high in fat, sodium and carbohydrates)  are also often more heavily marketed at the point-of-purchase in these stores. Acculturation has also led to cooking less at home and eating larger portions.

Co-Occurence of Diabetes

Roughly 30% of adult Hispanics have diabetes. The prevalence of diagnosed diabetes in Mexican Americans between the ages of 24 and 74 is 2.4 times greater than in non-Hispanic whites.

Diabetes and blood pressure co-occurence in Latinos

High Prevalence of Metabolic Syndrome

Metabolic syndrome is a combination of factors that multiply a person's risk for heart disease, diabetes and stroke. Having more than one of these conditions - increased blood pressure, a high blood sugar level, excess body fat around the waist, high triglycerides and abnormal cholesterol levels — greatly increases the risk of heart disease, stroke and diabetes.

This multi-front threat of being metabolically unhealthy can also make hypertension harder to control using just one or two drugs. Unfortunately,  taking more than three drugs does not decrease your risk of dying from heart disease.These co-occuring heart risk factors only multiply the need for culturally relevant resources for intervention.  The major mistake many Latinos make when it comes to heart risk is…Ignoring it!  If they don't see a specific problem, they assume they're fine.  But hypertension is called the silent killer specifically because it has no obvious associated symptoms (although premature aging and sexual dysfunction can be two early warning signs). You can have it for years without knowing it. This is dangerous because  left unidentified and untreated, high blood pressure can damage the body and lead to heart disease, heart failure, stroke and kidney failure.

Self-Reliance of Latinos Impacts Treatment and Solutions

Self Reliance in Latinos means they can self-manage blood pressure using an app

Raised to be self-reliant, Latinos tend to limit visits to doctors and treatment. In fact, 42% of Latinos report they have had zero visits to a medical provider.  They are also the minority group least likely to use prescription medication. That is the downside of self-reliance.The upside is that self-management can be highly effective for improving Latino heart health. For a population that desires to take health into their own hands and is smartphone-savvy, self-monitoring of blood pressure using an app (iOS, Android), for prevention or treatment, makes good practical and economic sense.

Self-Reliance + Smartphone + App --> Managed Blood Pressure

Tracking blood pressure is the critical first step to heart health. Self-monitoring and tracking has been shown to lower BP by 10 points or more.

BP Trends over time

Self-reliant Latinos can also benefit from other do-it-yourself self-management tips to lower blood pressure and reduce heart risk.

DIY: Lower your blood pressure by 10+ points

  • Track your BP - Tracking creates awareness and understanding which, if you build a routine,  is very effective for controlling blood pressure.
  • Reduce salt – Sodium creates high pressure in your arteries through high water retention.
  • Reduce breathing rate – Slow breathing exercises help decrease stress, which in turn lowers blood pressure.
  • Increase breathing rate – Get a cardio workout three times per week. This can lower your blood pressure by about eight points.
  • Increase tea – People drinking three cups of black tea every day for six months have seen a two-point drop in blood pressure.
  • Increase beets – Drinking beet juice has been associated with a reduction in blood pressure by up to five points.
  • Increase grapefruit  – One a day can reduce arterial narrowing by 46 percent and help drop your blood pressure by more than 5 points.
  • Increase laughter – A good laugh dilates your blood vessels.
  • Increase your DASH – Dietary Approaches to Stop Hypertension (DASH) focuses on menus made of fruits, veggies, whole grains, poultry, fish, beans, and nuts. It reduces sugars and salt. It is a close variant to the mediterranean diet. One study found that it lowered BP by up to 16 points.
Reward for tracking BP daily

THE GIST

  • Latinos are ahead of the curve in adopting smartphones than non-Hispanics
  • Latinos (particularly Mexican Americans) are at higher risk for hypertension than non-Hispanics.
  • Latinos tend to be at higher risk for other heart-related conditions.
  • Latino culture values self-reliance so awareness and self-management can have a huge practical and economic impact.
  • Latinos are uniquely positioned to successfully manage their blood pressure using smartphone apps.
Hello Heart is not a substitute for professional medical advice, diagnosis, and treatment. You should always consult with your doctor about your individual care.

1. Gazit T, Gutman M, Beatty AL. Assessment of Hypertension Control Among Adults Participating in a Mobile Technology Blood Pressure Self-management Program. JAMA Netw Open. 2021;4(10):e2127008, https://doi.org/10.1001/jamanetworkopen.2021.27008. Accessed October 19, 2022. (Some study authors are employed by Hello Heart. Because of the observational nature of the study, causal conclusions cannot be made. See additional important study limitations in the publication. This study showed that 108 participants with baseline blood pressure over 140/90 who had been enrolled in the program for 3 years and had application activity during weeks 148-163 were able to reduce their blood pressure by 21 mmHg using the Hello Heart program.) (2) Livongo Health, Inc. Form S-1 Registration Statement. https:/www.sec.gov/Archives/edgar/data/1639225/000119312519185159/d731249ds1.htm. Published June 28, 2019. Accessed October 19, 2022. (In a pilot study that lasted six weeks, individuals starting with a blood pressure of greater than 140/90 mmHg, on average, had a 10 mmHG reduction.) NOTE: This comparison is not based on a head-to-head study, and the difference in results may be due in part to different study protocols.
2. Validation Institute. 2021 Validation Report (Valid Through October 2022). https://validationinstitute.com/wp-content/uploads/2021/10/Hello_Heart-Savings-2021- Final.pdf. Published October 2021. Accessed October 19, 2022. (This analysis was commissioned by Hello Heart, which provided a summary report of self-fundedemployer client medical claims data for 203 Hello Heart users and 200 non-users from 2017-2020. Findings have not been subjected to peer review.)