Abstract P285: Psychosocial Factors are Associated with Blood Pressure Progression among African Americans in the Jackson Heart Study
Background: African Americans (AA) have a higher risk of hypertension than other race/ethnic groups. Research that examines the associations of psychosocial factors with longitudinal changes in blood pressure (BP) and incident hypertension among AA is limited. Using Jackson Heart Study (JHS) data, we hypothesized that negative affect and stress are positively associated with BP progression and incident hypertension among AA.
Methods: The JHS is an observational, community-based study of cardiovascular disease (CVD) in AA. Our sample consisted of 1,668 normotensive participants at baseline (2000-2004) (mean age 47±12; 61% women). We investigated sex-pooled associations of negative affect (cynical distrust, anger in, anger out and depressive symptoms) and stress (perceived stress, weekly stress inventory (WSI)-event, WSI-impact and negative life events) with BP progression (an increase by one BP stage as defined by JNC VII), incident hypertension and longitudinal changes in systolic and diastolic BP by examination 2 (2005-2008). Poisson regression analysis was utilized to examine the prevalence ratios (PR 95% CI) of BP tracking with psychosocial factors, adjusting for baseline age, sex, socioeconomic status (SES) and hypertension risk factors.
Results: Men had higher cynical distrust scores than women (p<.0001). Women had higher anger out, depressive symptoms and perceived stress scores than men (p<.05). Fifty six percent of the sample (934 cases) had BP progression from 2000 to 2008. After adjustment for age and sex, a high anger-out score was associated with a 20% increased prevalence of BP progression compared to a low anger-out score (PR 1.20, 95%CI 1.05,1.36). This association attenuated after adjustment for hypertension risk factors and became non-significant. High depressive symptoms score was associated with BP progression in the age, sex and SES-adjusted model (PR, 1.14 95%CI 1.00,1.30), but not in the fully-adjusted models. High WSI-event scores were associated with BP progression in the fully-adjusted model (PR, 1.21 95% CI 1.04,1.40). Psychosocial factors were not associated with incident hypertension.
Conclusions: Psychosocial factors were associated with BP progression, with the strongest evidence for number of stressful events that occurred. Further research is needed to better understand the pathway between exposure to negative affect and stress and BP progression among AA.
Keywords: psychosocial, hypertension, health disparities, African Americans, Jackson Heart Study
Author Disclosures: C.D. Ford: None. M. Sims: None. J.C. Higginbotham: None. M.R. Crowther: None. S.B. Wyatt: None. S.K. Musani: None. T.J. Payne: None. J. Parton: None.
- © 2014 by American Heart Association, Inc.