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Association of birthplace and self-reported hypertension by racial/ethnic groups among US adults – National Health Interview Survey, 2006–2010

Fang, Jing; Ayala, Carma; Loustalot, Fleetwood

doi: 10.1097/HJH.0b013e3283599b9a

Background: Over the past few decades, the proportion of US adults who were foreign-born has been increasing, as has the overall prevalence of hypertension. Here, we compared the prevalence of self-reported hypertension among native-born adults with that among foreign-born adults, classified by racial/ethnic group.

Methods: Using 2006–2010 data from the National Health Interview Survey (NHIS), we compared the age-adjusted prevalence of hypertension among native-born adults to foreign-born adults, specified by continent of birthplace and race/ethnicity. Results are expressed as unadjusted odds ratios (ORs) and three sets of adjusted odds ratios (AORs) adjusted for selected sociodemographic, behavioral and health-related characteristics. All results accounted for NHIS sampling design variables.

Results: The analytic sample was 124 260 with 16.3% foreign-born adults. Among the foreign-born adults, 56% were from Central or South America, 22% from Asia, 13% from Europe, and 4% from Africa. Overall and after adjustment, hypertension prevalence was significantly higher among US-born adults than among foreign-born adults (AOR: 1.28, 95% CI: 1.21–1.36). By race/ethnicity, hypertension prevalence was higher among US-born non-Hispanic blacks than either foreign-born non-Hispanic blacks (AOR: 1.24, 95%CI: 1.02–1.50) or all Africa-born immigrants of any race/ethnicity [AOR: 1.45, 95% confidence interval (CI): 1.07–1.97]. Among foreign-born adults, duration of US residence was positively associated with the likelihood of hypertension.

Conclusion: Hypertension prevalence was higher among US-born adults than among foreign-born adults and higher among US-born non-Hispanic blacks than in any other group. Among foreign-born adults, hypertension risk increased with the number of years they had lived in the United States.

Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Correspondence to Jing Fang, 4770 Buford Hwy, NE, MS F-72, Atlanta, GA 30341, USA. Tel: +1 770 488 5142; fax: +1 770 488 8151; e-mail:

Abbreviations: AOR, adjusted odds ratio; CI, confidence interval; NHIS, National Health Interview Survey; OR, odds ratio; SE, standard error

Received 24 April, 2012

Revised 17 August, 2012

Accepted 22 August, 2012

© 2012 Lippincott Williams & Wilkins, Inc.