Read Jen'nan Ghazal, Gorman Bridget K
Center for Health Policy Research, University of California, Irvine, CA 92697, USA.
Ethn Dis. 2007 Spring;17(2):389-96.
This study assesses racial/ethnic differences in the odds of hypertension among US adult women and examines the degree to which depression, in addition to demographic, socioeconomic status, and health lifestyle characteristics, account for observed differences.
The most recent iterations of the National Health Interview Survey (2001-2003) were used to examine the odds of hypertension among adult women aged > or =18. The sample consisted of non-Hispanic Whites (n=34,698), non-Hispanic Blacks (n=8,077), and Hispanics (n=9,055).
Age-adjusted hypertension rates were significantly higher for Black and Hispanic women than for White women. Sequential logistic regression models demonstrated that health lifestyle accounted for the largest portion of the racial/ethnic gap in hypertension, and depression had little mediating influence. Adjusting for all covariates reduced the gap between Black and White women somewhat, but Black women retained their elevated odds of hypertension (odds ratio [OR] 1.74, 95% confidence interval [CI] 1.60-1.90), while the gap between Hispanic and White women was reduced to nonsignificance (OR .99, 95% CI .90-1.11). Interaction tests revealed that the relationship between depression and hypertension differed across racial/ethnic groups; depression had a much stronger association with hypertension among Black and Hispanic women than among Whites.
After adjusting for age, Black and Hispanic women were more hypertensive than their White counterparts, and depression disproportionately increased their risk. Efforts to improve hypertension treatment and control would benefit from a better understanding of the link between mental and physical health among US minority groups.
本研究评估美国成年女性患高血压几率的种族/民族差异,并考察除人口统计学、社会经济地位和健康生活方式特征外,抑郁症在多大程度上能够解释所观察到的差异。
使用美国国家健康访谈调查(2001 - 2003年)的最新版本,研究年龄≥18岁成年女性患高血压的几率。样本包括非西班牙裔白人(n = 34698)、非西班牙裔黑人(n = 8077)和西班牙裔(n = 9055)。
经年龄调整后,黑人女性和西班牙裔女性的高血压患病率显著高于白人女性。逐步逻辑回归模型表明,健康生活方式在高血压的种族/民族差距中占最大比例,而抑郁症的中介作用较小。对所有协变量进行调整后,黑人女性和白人女性之间的差距有所缩小,但黑人女性患高血压的几率仍然较高(优势比[OR]为1.74,95%置信区间[CI]为1.60 - 1.90),而西班牙裔女性和白人女性之间的差距缩小至无统计学意义(OR为0.99,95%CI为0.90 - 1.11)。交互作用检验显示,抑郁症与高血压之间的关系在不同种族/民族群体中存在差异;抑郁症与黑人女性和西班牙裔女性高血压的关联比与白人女性的关联更强。
在调整年龄后,黑人女性和西班牙裔女性比白人女性患高血压的几率更高,且抑郁症使她们患病风险增加的比例更高。更好地理解美国少数群体心理与身体健康之间的联系,将有助于改进高血压的治疗和控制工作。