American Journal of Hypertension
Volume 32, Issue 1, 2019, Pages 104-111

Hypertension Prevalence Jointly Influenced by Acculturation and Gender in US Immigrant Groups (Article)

Divney A.A.* , Echeverria S.E. , Thorpe L.E. , Trinh-Shevrin C. , Islam N.S.
  • a Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States, NYU-CUNY Prevention Research Center, New York, United States
  • b Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States, NYU-CUNY Prevention Research Center, New York, United States
  • c NYU-CUNY Prevention Research Center, New York, United States, NYU School of Medicine, Department of Population Health, New York, NY, United States
  • d NYU-CUNY Prevention Research Center, New York, United States, NYU School of Medicine, Department of Population Health, New York, NY, United States
  • e NYU-CUNY Prevention Research Center, New York, United States, NYU School of Medicine, Department of Population Health, New York, NY, United States

Abstract

BACKGROUND Latinos and Asians in the United States are disproportionately burdened by hypertension, a leading risk factor for cardiovascular disease. Few studies have used multicomponent measures of acculturation to compare cardiovascular risk factors across immigrant-origin groups. Additionally, little is known about how acculturation and gender shape hypertension risk among immigrants. METHODS We created an acculturation score composed of language use, nativity, and years in the United States and fit separate race/ethnicity log-binomial models examining associations with hypertension prevalence (≥130/80 mm Hg) among Latino (n = 4,267) and Asian (n = 2,142) National Health and Nutrition Examination Survey 2011-2016 participants aged 18+. Joint effect models tested the concept of "intersectionality" between acculturation and gender. RESULTS Adjusting for age, gender, and socioeconomic position, Latinos and Asians with high acculturation were 25% and 27% more likely to have hypertension, respectively, compared with low acculturation groups. Latino and Asian American men with high levels of acculturation were 74-79% more likely to have hypertension compared with women with low acculturation (adjusted prevalence ratios (aPR) for Latinos = 1.74, 95% confidence interval (CI): 1.49-2.03; aPR for Asians = 1.79, 95% CI: 1.42-2.25). The gradient of increasing hypertension with increasing acculturation was most apparent among Latino men (adjusted risk differences (aRD) = 12.0%, P < 0.001) and Asian women (aRD = 14.0%, P = 0.003) and nonsignificant among Latino women and Asian men when comparing high vs. low acculturation categories. CONCLUSIONS Our results correspond with prior literature demonstrating increased morbidity among immigrants with increasing acculturation but also suggest differing patterns by race/ethnicity and gender. Future research should explore how migration processes differentially influence hypertension among men and women. © 2018 American Journal of Hypertension, Ltd.

Author Keywords

Latino Immigrant health Hypertension Asian Acculturation blood pressure

Index Keywords

Asian race difference human sex difference middle aged antihypertensive therapy priority journal comparative study hypertension Aged language hypertensive patient United States Young Adult cross-sectional study ethnic difference Hispanic male Asian American female cultural factor prevalence Article major clinical study adult antihypertensive agent systolic blood pressure diastolic blood pressure health survey

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85058501870&doi=10.1093%2fajh%2fhpy130&partnerID=40&md5=bfde892024d42999920514a478d8e230

DOI: 10.1093/ajh/hpy130
ISSN: 08957061
Original Language: English