The association between acculturation and hypertension in a multiethnic sample of US adults

Previous studies analyzing acculturation and cardiovascular risk were restricted to individual race/ethnic groups and did not fully account for potential confounders. We examined the independent association between acculturation and hypertension in a contemporary multiethnic sample that included white, black, Latino, and Asian individuals. We examined 51,048 participants in the 2007 California Health Interview Survey who were >18 years, 59.5% of whom were women. The main exposure-of-interest was acculturation score, a summary measure of the additive effect of 4 variables (country of birth, parents’ country of birth, language at home, and duration of stay in the United States) ranged from 0 (least acculturation) to 4 (highest acculturation). We found that increased acculturation was associated with hypertension, independent of age, gender, race/ethnicity, education, smoking, alcohol, physical activity, body mass index, and diabetes. Compared with those with the lowest acculturation (score of 0), the multivariable odds ratio (95% confidence interval) of hypertension among those with the highest acculturation (score of 4) was 1.78 (1.50–2.11). This association between acculturation and hypertension was consistent in subgroup analyses by gender, education, smoking, alcohol intake, and body mass index. Increased Western acculturation was found to be positively associated with hypertension in a multiethnic sample, independent of confounders.