fiveoboy01
Pattern Altitude
No, they mean heading. They know what the winds are - All the airplanes are affected by them. If they say "fly heading 090" that's what they mean - Fly the heading. If they want you to fly a course, they'll tell you so, though it'll usually be "maintain west of xxx".
Related question.... if the tower says to fly runway heading, are you supposed to follow the extended centerline of the runway or let the airplane drift without wind correction? If I'm into the wind it doesn't matter, but if there is a significant crosswind....