Relation of Self-Reported Race and Genetic Ancestry to Hypertension Prevalence Among Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos

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Abstract
Background: The imprecision of current metrics to capture the complex genetic admixture and racial identity among Hispanic/Latino individuals in the United States (US) is a concern. We examined the relationship of self-reported race and genetic ancestry with hypertension (HTN) among Hispanics/Latinos. Methods: Cross-sectional study of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), including 10,586 Hispanic/Latino unrelated adults. Genetic ancestry: West African (AA), Amerindian (AI), and European (EA). Self-reported race: White, Black, Native American, or Multiple/Missing ( More than one race or Unknown/Not reported/Refused ). HTN: systolic (SBP) ≥130 mmHg, diastolic blood pressure (DBP) ≥80 mmHg, and/or use of HTN medications. Age- and sex adjusted models were used. Results: Self-reported race was White (38·6%), Black (3·6%), Native American (4·1%), and Multiple/Missing (53·7%), with Unknown/Not reported/Refused representing 32·7%. Black and White Hispanics/Latinos had the greatest AA (55·7%) and EA (69·3%) ancestries, respectively. Each 10% AA increase was associated with OR 1·15, SBP beta +0.9 mmHg, and DBP beta +0.7 mmHg. Conversely, each 10% AI increase was associated with OR 0·83, SBP beta -0·4 mmHg, and DBP beta -0·6 mmHg. HTN prevalence was highest among those with Black race or in the highest AA quantile (45·6% and 48·0%, respectively), and lowest among those with Native American race or in the highest AI quantile (37·6% and 26·7%, respectively). Conclusion: One-third of Hispanics/Latinos did not self-report race. Black or White self-reporting race did somewhat relate to AA or EA ancestry, respectively. HTN profiles were related to self-reported race and genetic ancestry in this admixed population.

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