Native Hawaiians bear a disproportionate burden of hypertension. Discrimination and depression are potential hypertension risk factors. Although the relationship between discrimination and depression is well established, how these factors affect hypertension risk in indigenous populations remains unknown. We examined the relationship between discrimination, depression, and hypertension in adult Native Hawaiians. We hypothesized that greater frequency of perceived discrimination and greater frequency of depressive symptoms would independently increase the likelihood of having hypertension. Surveys were mailed to 540 adult Native Hawaiians residing on five Hawaiian Homesteads. The surveys measured: hypertension status, sociodemographic factors (age, gender, income, employment status), body mass index (BMI), physical activity frequency, smoking, Hawaiian cultural affiliation, American cultural affiliation, perceived discrimination, and depressive symptoms. Respondents (n=171) were mostly female (71%), a mean age of 57yrs, and 54% reported having hypertension. The logistic regression model included perceived discrimination, depression, BMI, frequency of vigorous physical activity, and Hawaiian cultural affiliation, and sociodemographic variables. The model showed that Hawaiian cultural affiliation and discrimination were significantly related to hypertension status. Depression was not related to hypertension status. Interaction analysis found that for individuals with lower Hawaiian cultural affiliation, frequent perceived discrimination was significantly associated with lower odds of having hypertension. The negative association between perceived discrimination and hypertension status was opposite from hypothesized. However, the interaction suggests this relationship holds only for less culturally affiliated individuals. These results underscore the varied nature of hypertension determinants and may have clinical implications for the treatment of hypertension in Native Hawaiians.

中文翻译：

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对夏威夷原住民歧视、抑郁和高血压之间关系的研究。

夏威夷原住民承受着不成比例的高血压负担。歧视和抑郁是潜在的高血压危险因素。尽管歧视和抑郁症之间的关系已明确，但这些因素如何影响土著人群的高血压风险仍不清楚。我们研究了成年夏威夷原住民的歧视、抑郁和高血压之间的关系。我们假设，感知歧视的频率越高，抑郁症状的频率越高，患高血压的可能性就会独立增加。调查问卷已邮寄给居住在五个夏威夷家园的 540 名成年夏威夷原住民。调查测量了：高血压状况、社会人口因素（年龄、性别、收入、就业状况）、体重指数（BMI）、体力活动频率、吸烟、夏威夷文化归属、美国文化归属、感知歧视和抑郁症状。受访者 (n=171) 大部分为女性 (71%)，平均年龄为 57 岁，54% 的人患有高血压。逻辑回归模型包括感知歧视、抑郁、体重指数、剧烈体育活动的频率、夏威夷文化归属和社会人口统计学变量。该模型显示夏威夷文化归属和歧视与高血压状况显着相关。抑郁症与高血压状态无关。交互分析发现，对于夏威夷文化背景较低的人来说，经常感受到的歧视与患高血压的几率较低显着相关。感知歧视与高血压状况之间的负相关与假设相反。然而，这种互动表明这种关系只适用于文化关联程度较低的个体。这些结果强调了高血压决定因素的不同性质，可能对夏威夷原住民高血压的治疗具有临床意义。