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Risk Factors in Adolescence for the Development of Elevated Blood Pressure and Hypertension in American Indian and Alaskan Native Adults


To examine risk factors for elevated blood pressure and hypertension in American Indians and Alaska Natives (AI/ANs), compared to three other ethnic groups in the US. Weighted relative risk regression models, stratified by race/ethnicity, were used to measure the associations between risk factors and elevated blood pressure and hypertension in AI/ANs, compared to non-Hispanic Whites, non-Hispanic Blacks and Hispanics, with data from the National Longitudinal Study of Adolescent to Adult Health. In all groups, females had a lower risk of both elevated blood pressure and hypertension than males. Increasing body mass index raised hypertension risk in all groups. In AI/ANs, financial instability increased the risk of hypertension by 88% (95% CI: 1.27–2.77), but not in other groups. No other statistically significant associations were found. Future interventions should include socio-economic factors in efforts to prevent hypertension in AI/ANs.

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The authors received funding from a Research Supplement to Promote Diversity in Health-Related Research from the National Institute on Minority Health and Health Disparities (D. Buchwald, Principal Investigator, and A. Zamora-Kapoor, long-term investigator), support from an infrastructure grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R24 HD042828, S. Curran, Principal Investigator) and support from the Health Equity Research Center, a strategic research initiative at Washington State University, for the research and publication of this article.

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Correspondence to Anna Zamora-Kapoor.

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Zamora-Kapoor, A., Hebert, L.E., Montañez, M. et al. Risk Factors in Adolescence for the Development of Elevated Blood Pressure and Hypertension in American Indian and Alaskan Native Adults. J Immigrant Minority Health 23, 717–724 (2021).

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  • American Indian
  • Alaska Native
  • Risk factors
  • Blood pressure
  • Hypertension