Factors associated with hypertension among Asians and Pacific Islanders in Urban and Rural Alaska

INTRODUCTION: For the past two decades, Asians and Pacific Islanders (APIs) have significantly grown in Alaska, making them the second largest minority group in the state. Despite their large presence, there have been no published studies on their health conditions and the factors that influence them.  With heart disease and stroke as the leading causes of death among APIs, key informant interviews with API groups and leaders in Alaska identified hypertension as one of their major health concerns.  To address the concerns of the API communities in Alaska, we conducted an exploratory study, with the purpose of identifying factors associated with hypertension among APIs in Alaska.

METHODS: We surveyed 225 APIs, 18 years and above, in one urban and two rural Alaskan communities with large API population.  Surveys were self-administered and done by convenience sampling.  Survey questionnaire covered various topics, including lifestyle, health behaviors and conditions, and psychosocial issues.  We entered and analyzed our data on SPSS.  We ran logistic regressions to assess whether there is an independent association between hypertension and acculturation, living in rural or urban community, race/ethnicity, mental distress, discrimination, social support, and obesity, controlling for age, education, and gender. Post-hoc analyses were run to determine factors associated with the items identified to have significant association with hypertension.

RESULTS: Approximately 31% of our sample reported being diagnosed with hypertension.  Filipinos (OR=2.8) and those who are overweight/obese (OR=2.9) have greater odds of having hypertension.  Post regression analysis show that those who are overweight/obese compared to their counterpart are more likely to have poorer diet and lack physical activity. However, no significant lifestyle factors were found to be associated with high hypertension rates among Filipinos.

CONCLUSIONS:   Findings suggest that hypertension among APIs may be influenced by the type of community they live and perhaps affected by the unique Alaskan environmental challenges they encounter. Changes in cultural beliefs and practices, as well as genetics may also play a role in increasing the risk for hypertension.