Native Hawaiians have been reported to experience high mortality from heart disease. Hypertension is a leading risk factor for cardiovascular morbidity and mortality. The authors report a cross-sectional study of the relationship of blood pressure and degree of Hawaiian ancestry (DHA) among 572 participants, aged 30 and older. Blood pressure was measured using the mean of the second and third of 3 measurements; hypertension was defined as either SBP> or =140, or DBP> or =90, or having a previous history of hypertension. Degree of Hawaiian ancestry (DHA) (<25%, 25%-49%, 50%-74%, 75%-99% and 100%) was assessed by a brief genealogical interview. Multiple logistic and linear regression techniques were used to adjust for potential confounding from age, body weight, central adiposity, metabolic factors, dietary factors, level of physical activity, social support, and depression symptoms. The prevalence of hypertension by DHA groups was 23.4%, 42.2%, 46.0%, 51.8%, and 34.6%, after adjusting for age, gender, and body mass index. Likewise, mean systolic and diastolic blood pressures were significantly associated with DHA. The association between diastolic blood pressure (DBP) and DHA persisted after adjustment for all demographic, biochemical, and behavioral risk factors. These results suggest that percentage of Hawaiian ancestry may act as a marker for important cultural or genetic risk factors for hypertension.