Date of Conferral

1-1-2010

Degree

Ph.D.

School

Health Services

Advisor

Aparna Sundaram

Abstract

Racial/ethnic disparities persist in hypertension (HTN) prevalence in the United States, and African Americans are disproportionately affected. The incidence is more than two-folds in African Americans compared to Caucasians, and mortality is highest among African Americans. Understanding the risk factors in HTN and how these factors vary across racial/ethnic groups is essential to reducing the mortality among African Americans. This study examined the prevalence of HTN among a sample non-institutionalized U.S. residents (N = 30,852), assessed racial/ethnic disparities and determined factors associated with racial/ethnic variance in HTN. A cross-sectional design was used to address these aims, utilizing the National Health Interview Survey, 2003 dataset. Chi square and logistic regression techniques were employed in the data analyses. The race-nonspecific prevalence of HTN was 26.7% (N = 8,243). African Americans had the highest prevalence (35.5%), Caucasians (27.5%), and Hispanics (18.6%), p < 0.01. African Americans were 45% more likely to be hypertensive relative to Caucasians, Odds Ratio (OR) = 1.45, 99% Confidence Interval (CI), 1.16-1.82. African Americans significantly differed from Caucasians in the factors that were associated with HTN: smoking, alcohol, physical activities, age, higher income, college education, body mass index, marital status, higher cholesterol and diabetes mellitus. After controlling for these factors, ethnic/racial disparities in HTN persisted. Compared to Caucasian, African Americans had a 61% increased in HTN prevalence, (OR = 1.61, 99% CI, 1.39-1.86) and Hispanics had a 27% decreased prevalence, (OR = 0.73, 99% CI, 0.68-0.79). Confirming that HTN differed by race/ethnicity while controlling for associated factors, this study contributes to positive social change by highlighting the importance of biologic or biologic-environmental interactions for future research or intervention planning.

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