Abstract 17388: Applicability of a Western Model of Hypertension in a Yup'ik Eskimo Population
Hypertension (HT) is a powerful contributor to cardiovascular disease. Importantly, HT is becoming increasingly common in non-western and rural contexts. While much literature has clarified the role of- and risk factors for HT in urban, western contexts little is known about the relevance of these results to other populations. This abstract explores the applicability of a western model of HT to a sample of Yup'ik Eskimo people. As part of the Center for Alaskan Native Health Research study we interviewed Yup'ik individuals residing in 7 rural villages located in Southwestern Alaska. Covariates of interest were age, sex, education, body composition, physical activity, tobacco use, household composition, and ethnic identification. We assessed the association between vascular risk factors and the odds of having either normal (systolic 120 to 129 mmHg) or borderline to hypertensive (systolic ≥ 130 mmHg) as compared to optimal (systolic < 120 mmHg) blood pressure with multinomial logistic regressions. Data comes from 1015 Yup'ik individuals: 54% female, mean age 37.6 (SD 17.4). Mean systolic BP was 120.07 mmHg, 20.7% had systolic BP ≥ 130 mmHg. In our final model age (one year increase; odds ratio = 1.06), male sex (1.46), waist circumference (one cm increase; 1.04), ever smoking tobacco (1.31), being single (compared to married; 1.44), and having 4 or more biological children (compared to none; 0.74) were associated with having borderline or definite hypertension. A similar pattern was observed for the presence of normal blood pressure as compared to optimal blood pressure - age (1.02), male sex (1.79), waist circumference (1.02), ever smoking tobacco (1.21), and being single (compared to married; 1.62). There were no direct effects of education, physical activity, or ethnic identification on the odds of HT. Interactions suggest individuals identifying highly with both Yup'ik and White culture have slower age related increases in HT, and that high levels of education negate differences in HT across all categories of ethnic identification. HT is emerging as an important risk factor among Yup'ik and other Alaskan Native people. Western models for HT may be applicable to Alaska Native populations; differences may elucidate causes and mechanisms across populations.
- © 2011 by American Heart Association, Inc.