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

A. A. Divney, S. E. Echeverria, Lorna Thorpe, C. Trinh-Shevrin, N. S. Islam

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)104-111
Number of pages8
JournalAmerican Journal of Hypertension
Volume32
Issue number1
DOIs
StatePublished - Jan 1 2019

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Acculturation
Hypertension
Hispanic Americans
Confidence Intervals
Asian Americans
Nutrition Surveys
Statistical Models
Cardiovascular Diseases
Language

ASJC Scopus subject areas

  • Internal Medicine

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Hypertension Prevalence Jointly Influenced by Acculturation and Gender in US Immigrant Groups. / Divney, A. A.; Echeverria, S. E.; Thorpe, Lorna; Trinh-Shevrin, C.; Islam, N. S.

In: American Journal of Hypertension, Vol. 32, No. 1, 01.01.2019, p. 104-111.

Research output: Contribution to journalArticle

Divney, A. A. ; Echeverria, S. E. ; Thorpe, Lorna ; Trinh-Shevrin, C. ; Islam, N. S. / Hypertension Prevalence Jointly Influenced by Acculturation and Gender in US Immigrant Groups. In: American Journal of Hypertension. 2019 ; Vol. 32, No. 1. pp. 104-111.
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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.",
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AB - 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.

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