Affiliation:
1. Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill North Carolina, USA
2. Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
3. National Institutes of Health, Bethesda, Maryland, USA
4. Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
Abstract
Abstract
BACKGROUND
Limited research has examined the association of life-course socioeconomic status (SES) with hypertension prevalence and incidence in a large cohort of African Americans.
METHODS
Among 4,761 participants from the Jackson Heart Study (JHS), we examined the association of SES indicators with prevalent and incident hypertension. We used multivariable Poisson regression to estimate prevalence ratios (PR, 95% confidence interval—CI) of baseline (2000–2004) hypertension by adult (education, income, occupation, wealth) and childhood (mother’s education) SES. Cox proportional hazards regression was used to estimate hazard ratios (HR, 95% CI) of incident hypertension by adult and childhood SES (2005–2013; 7.21 median years of follow-up). We also examined the association of childhood-to-adult SES mobility (parent-to-adult education) with prevalent and incident hypertension. Model 1 adjusted for age and sex. Model 2 added waist circumference, behaviors (smoking, alcohol, physical activity, diet), and diabetes prevalence.
RESULTS
High (vs. low) adult SES measures were associated with a lower prevalence of hypertension, with the exception of having a college degree and upper-middle income (PR: 1.04, 95% CI: 1.01, 1.07; PR: 1.05, 95% CI: 1.01, 1.09, respectively). Higher childhood SES was associated with a lower prevalence and risk of hypertension (PR: 0.83, 95%: CI 0.75, 0.91; HR: 0.76, 95% CI: 0.65, 0.89, respectively). Upward mobility and consistent high SES (vs. consistent low SES) from childhood to adulthood was associated with a greater prevalence, but lower incidence of hypertension.
CONCLUSION
Efforts to prevent hypertension among African Americans should consider childhood and current SES status.
Funder
The Jackson Heart Study
Jackson State University
Tougaloo College
Mississippi State Department of Health
University of Mississippi Medical Center
National Heart, Lung, and Blood Institute
National Institute for Minority Health and Health Disparities
American Heart Association
Genetic Epidemiology of Heart, Lung, and Blood Traits Training Grant
Publisher
Oxford University Press (OUP)
Cited by
34 articles.
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