Growing up as a Filipino American, I was raised in a culture that highly valued family and tradition, and those two values were celebrated with aunties, uncles, and cousins over delicious Filipino food.
Filipino cuisine is not only rich in culture, but it is also rich in flavor. However, it is a flavor imparted by tasty yet salt-heavy ingredients such as soy sauce, MSG, fish sauce, and shrimp paste, which are added during cooking and often eaten alongside the dishes after cooking.
We spent holiday parties and weekly family gatherings over-filling our plates from an abundant buffet table with hearty meat and veggie soups and stews, deep-fried eggrolls, and savory noodle dishes. The satisfying meals were followed by hours of karaoke, competitive poker, mahjong games, juicy gossip, shots of Wild Turkey, or the big game or Pacquiao fight. There was occasional dancing, but otherwise, no physical activity.
As much as I enjoyed making these lasting memories with my family, as I got older and advanced in my nursing career, I realized how this pattern of a high-sodium diet and a sedentary lifestyle was detrimental to the cardiovascular health of my parents and loved ones.
Prevalence of HTN in Filipino Americans
Among various ethnic groups, studies have consistently shown that Filipino Americans (FAs) have the highest rates of hypertension prevalence (51.2%-79.0%) compared to other Asian Americans and non-Hispanic Whites (NHWs).
Of the various Asian American subgroups, Filipino Americans treated for hypertension (HTN) have the lowest rates of achieving blood pressure control.
A physical activity assessment done on FAs with HTN living in the southwestern region of the U.S. showed that they did not meet the American Heart Association’s recommendations for physical activity, strength, and flexibility.
Significance of HTN in Filipino Americans
The findings above startle me and become more significant as the Filipino American community grows and ages.
FAS must stay healthy for their well-being and quality of life and, in a broader context, their contributions to society and the workforce.
A systematic review showed, “Filipino immigration has filled labor shortages in agriculture, the military, and nursing, and Filipino Americans are overrepresented in these important workforces.” Moreover, these job roles require one to be healthy, spry, and active.
What We Can Do as Nurses
When providing culturally competent care to FAs, some lifestyle and behavioral teaching points to include are:
- Reinforcing the DASH (Dietary Approaches to Stop Hypertension) diet
- Promotes fruits, vegetables, and lean meats
- Restricts added sugars and fats, and red meats
- Recommends less than 1500mg (3/4 tsp) of sodium per day
- Encouraging a diet full of familiar, native but accessible green leafy vegetables such as malunggay, spinach, and kangkong, which are known to lower blood pressure
- Introducing ways to limit sodium, such as adding herbs and spices instead of salty ingredients and avoiding processed foods like spam and hot dogs
- Promoting enjoyable, relatable physical activities such as gardening, Zumba, dancing, and daily walking
- Emphasizing alcohol limitation and moderation
- Reinforcing the importance of weight loss
- Including family in educational opportunities and discharge instructions. Filipinos are shown to practice collectivism, in which they include family and friends in decision-making to think about the greater good of everyone involved
To address this health disparity, nurses must be mindful of its existence and be influential in its prevention and treatment.
FA nurses, who comprise about 150,000 of the nurse workforce in the U.S., should foster trust and use teaching opportunities with fellow Filipino patients to educate, treat, and advocate for this high-risk minority.