Immigration emergency in Italy. The impact of socioeconomic status on blood pressure levels and control

Introduction Nowadays there are more than 5 millions of immigrants (8.3% of general adult population) in Italy. Aim To evaluate the potential impact of immigration and the possession of a permanent residence on blood pressure (BP) levels and control in a low income population of immigrants from di erent countries. Methods We evaluated clinical characteristics and social status of adult individuals with known diagnosis of hypertension a erent to the Poliambulatorio della Caritas Diocesana in Rome, Italy, between 2010–2016. Subjects were strati ed accord- ing to their macro-areas of origin (Europe, Asia, Africa, South-America), housing (with or without house), and immigration status (presence or absence of residence permit). BP levels were measured in three consecutive visits according to recom- mendations from current European Guidelines. Results From an overall population sample of 9827 adult individuals, we initially identi ed 994 patients with a diag- nosis of hypertension (10.1%), among whom 536 (5.4%) had valid BP data. Among these, 50.6% came from Europe, 21.6% from Africa, 24.1% from Asia, and 3.7% from South-America. They were predominantly male (54.7%), middle aged (42.8 ± 12.1 years at arrival and 51.6 ± 10.6 years at rst visit) and untreated (72.8%) individuals with baseline systolic/dias- tolic BP levels of 156.9 ± 22.2/97.3 ± 12.4 mmHg). BP levels remained higher in homeless than in housed people at both visit 2 (150.0 ± 21.8/92.6 ± 12.9 mmHg vs. 142.9 ± 19.3/89.9 ± 11.6 mmHg; P < 0.001) and visit 3 (147.9 ± 22.2/91.7 ± 12.5 mmHg vs. 141.8 ± 19.4/89.2 ± 12.0 mmHg; P = 0.013). We also observed reductions of both systolic and diastolic BP levels compared to baseline values in immigrants strati ed according to residence permit, although without relevant di erences among groups. Conclusions Beyond conventional risk factors, socio-economic issues, including lack of residence permit or habitation, may a ect BP levels and control in frail populations of immigrants, which have been marginally considered before.