Racial/ethnic differences in hypertension and depression among US adult women.

Objectives: 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.

Methods: 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).

Results: 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.

Conclusions: 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.