Abstract 17283: Neighborhood-Level Socioeconomic Deprivation Predicts Worsening Blood Pressure in a Multi-Ethnic Population: Longitudinal Data From the Dallas Heart Study
Background: Living in socioeconomically deprived neighborhoods can increase risk of cardiovascular (CV) events; however, mechanisms through which events occur are unclear. Specifically, little is known about the relationship between neighborhood socioeconomic deprivation and blood pressure (BP) change over time, a potential source of CV risk.
Methods: We examined the relationship between neighborhood socioeconomic deprivation and BP change among those who did not move in the 7-year study period (N=939) of the Dallas Heart Study (DHS), a multi-ethnic sample of Dallas County residents aged 18-65 years. BP measurements were performed in 2000-02 and at 7-year follow-up. Geocoded baseline and follow-up home addresses were linked to census block groups in Dallas County. A block group-level neighborhood deprivation index (NDI) was created (higher score = more socioeconomic deprivation). Among persons without baseline hypertension (systolic BP ≥ 140 and/or diastolic BP ≥ 90) [HTN], repeated measures linear mixed modeling was used to determine BP change (mmHg) relative to 1-unit increase in NDI and logistic regression modeling was used to determine odds of HTN for those in the highest vs. lowest NDI tertile.
Results: DHS participants living in more socioeconomically deprived neighborhoods had higher baseline SBP (134±21 vs 124±16 mmHg), DBP (81±10 vs 78±9 mmHg) and higher prevalent HTN (all p<0.001). Among those without baseline HTN (N=533), SBP (3.1±0.8 mmHg, p<0.01) and DBP (2.3±0.4 mmHg, p<0.01) increased per 1-unit increase in NDI, independent of sex, race, and time-updated covariates (age, smoking, education, income, physical activity, length of residence, body mass index). Odds of incident HTN during the follow-up period was higher for those in the highest vs lowest NDI tertile (OR 2.2, 95% CI 1.4 - 3.6); however, this relationship was attenuated in fully adjusted models (OR 1.8, 95% CI 0.8 - 3.8).
Conclusions: Higher neighborhood socioeconomic deprivation was associated with increasing BP over time in DHS participants. While strategic policy measures might greatly improve neighborhood deprivation, our findings support a need for community-level interventions aimed at improving CV health, in addition to standard individual-level interventions.
- © 2013 by American Heart Association, Inc.