Level of acculturation and hypertension among Dallas County Hispanics: Findings from the Dallas Heart Study

PURPOSE: The purpose of this study is to examine whether the prevalence of hypertension differs by acculturation status among Hispanics in Dallas County, Texas. The authors test the hypothesis that compared with those of low acculturation, those of mid- and high-level acculturation will be at greater risk for having hypertension. METHODS: Conducted from July 2000 through October 2002, the Dallas Heart Study (DHS) is a general population cross-sectional study of cardiovascular risk factors among Dallas County residents. These analyses focus on the 1163 DHS participants who self-reported Hispanic ethnicity, completed a household interview, and had blood pressures measured. Acculturation was assessed with a validated 12-item scale that measured the following dimensions of cultural adaptation: language; media preference; social interaction; and ease of relationships with those of other ethnicities. RESULTS: The majority of participants were born in Mexico (57.5%) and ranged in age from 18 to 65 years (mean age 33 years). Women made up just under half of the sample (47.81%). The unadjusted prevalence of hypertension was 9.78%. When age-adjusted for the 2000 US Standard Population, the prevalence was 17.27%. The χ² analysis showed that those of low acculturation were significantly less likely to have hypertension (6.05%) than those of mid- and high-level acculturation (10.78% and 12.80%, respectively). After controlling for the effects of possible confounders (i.e., sociodemographic factors, health care access and utilization, health behaviors, and health status), logistic regression showed that when compared with Hispanics of low acculturation, those of middle and high acculturation were at greater risk of having hypertension (OR = 3.04, 95% CI, 1.27, 7.29 and OR = 2.62, 95% CI, 1.04, 6.59, respectively). CONCLUSION: These findings demonstrate that acculturation is significantly associated with hypertensive status.