Hypertension and social determinants in a cohort of migrants acceding an outpatient clinic in Rome

Background Cardiovascular diseases are the 1st cause of death globally. In many countries the prevalence of hypertension is higher among migrants than in native population. In this study, we evaluated hypertension prevalence and control in a cohort of migrants accessing an outpatient clinic in Rome. Other factors involved in pressure control, in particular socioeconomic determinant, juridical status and housing condition, have been examined. Methods A retrospective analysis has been carried out among patients with a diagnosis of hypertension accessing the clinic from 1st January 2010 to 31st December 2016. We evaluated the association between blood pressure levels before and after therapy administration, comorbidities related to hypertension (through a score going from 0, 'no comorbidities', to 6, 'all comorbidities'), juridical status and housing condition. A descriptive and inferential statistical analysis has been assessed to evaluate associations between these variables. Results According our criteria, we identified 994 subjects with hypertension (prevalence 10%), on a total of 9827 patients accessing the clinic in the same period. Among a total of 536 patients with available and readable clinical folder, 243 (45.3%) were women, 287 patients (53.2%) were homeless and 307 (57.3%) came from extra European countries; among them 151 (49.2%) were undocumented. Hypertension control over time was significantly worse in homeless than homed people (p < 0.01). Furthermore, undocumented and European people have a significantly worse comorbidity score (p < 0.05 and p < 0.01) than documented ones. Conclusions Our study emphasize that housing is a major determinant in the continuity of care for migrants with hypertension. Consequently, appropriate social and health strategies, as sustaining low threshold outpatient clinics, are essential to take care of chronic migrant patients, especially if undocumented, and to overcome difficulties they have in accessing Italian National Health System. Key messages: Housing is a major determinant of the continuity of care for migrants with hypertension Appropriate strategies are needed for treating hypertension with comorbidities in undocumented migrants