Psychosocial Factors Are Associated With Blood Pressure Progression Among African Americans in the Jackson Heart Study

Cassandra D Ford; Mario Sims; John C Higginbotham; Martha R Crowther; Sharon B Wyatt; Solomon K Musani; Thomas J Payne; Ervin R Fox; Jason M Parton

doi:10.1093/ajh/hpw013

Psychosocial Factors Are Associated With Blood Pressure Progression Among African Americans in the Jackson Heart Study

Am J Hypertens. 2016 Aug;29(8):913-24. doi: 10.1093/ajh/hpw013. Epub 2016 Mar 10.

Authors

Cassandra D Ford¹, Mario Sims², John C Higginbotham³, Martha R Crowther⁴, Sharon B Wyatt⁵, Solomon K Musani², Thomas J Payne⁶, Ervin R Fox², Jason M Parton⁷

Affiliations

¹ Capstone College of Nursing, The University of Alabama, Tuscaloosa, Alabama, USA; ford039@ua.edu.
² Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA;
³ College of Community Health Sciences, The University of Alabama, Tuscaloosa, Alabama, USA;
⁴ Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA;
⁵ Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA; School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA;
⁶ Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, Mississippi, USA;
⁷ Culverhouse College of Commerce and Business Administration, The University of Alabama, Tuscaloosa, Alabama, USA.

Abstract

Background: Research that examines the associations of psychosocial factors with incident hypertension among African Americans (AA) is limited. Using Jackson Heart Study (JHS) data, we examined associations of negative affect and stress with incident hypertension and blood pressure (BP) progression among AA.

Methods: Our sample consisted of 1,656 normotensive participants at baseline (2000-2004) (mean age 47±12; 61% women). We investigated 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 major life events) with BP progression (an increase by one BP stage as defined by JNC VII) and incident hypertension by examination 2 (2005-2008). Poisson regression analysis was utilized to examine the prevalence ratios (PRs; 95% confidence interval (CI)) of BP tracking and incident hypertension with psychosocial factors, adjusting for baseline age, sex, socioeconomic status (SES), and hypertension risk factors.

Results: Fifty-six percentage of the sample (922 cases) had BP progression from 2005 to 2008. After adjustment for age, sex, and SES, a high anger-out score was associated with a 20% increased risk of BP progression compared to a low anger-out score (PR 1.20; 95% CI 1.05-1.36). 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). High WSI-event scores were associated with BP progression in the fully adjusted model (PR 1.21; 95% CI 1.04-1.40). We did not observe significant associations with any of the psychosocial measures and incident hypertension.

Conclusions: Psychosocial factors were associated with BP progression, with the strongest evidence for number of stressful events that occurred.

Keywords: African Americans; Jackson Heart Study; blood pressure; health disparities; hypertension; psychosocial..

Publication types

Observational Study
Research Support, N.I.H., Extramural

MeSH terms

Adult
Affect / physiology*
Aged
Aged, 80 and over
Black or African American / psychology*
Blood Pressure
Disease Progression
Female
Humans
Hypertension / etiology*
Hypertension / psychology
Male
Middle Aged
Stress, Psychological / physiopathology*
Young Adult

Abstract

Publication types

MeSH terms

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