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  • 1
    Online Resource
    Online Resource
    Abstract 59: Social Determinants of Health and Incident Apparent Treatment Resistant Hypertension in a National Cohort of Black and White US Adults
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Circulation Vol. 147, No. Suppl_1 ( 2023-02-28)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 147, No. Suppl_1 ( 2023-02-28)
    Abstract: Background: Identifying social determinants of health (SDOH) associated with incident apparent treatment resistant hypertension (aTRH) may guide interventions to reduce the incidence of aTRH and its associated cardiovascular disease risk. Methods: We analyzed data from 2,769 White and 2,254 Black US adults from the REasons for Geographic and Racial Differences in Stroke study taking antihypertensive medication with controlled blood pressure (BP) at baseline to estimate the association of SDOH with incident aTRH. SDOH were guided by the Healthy People 2030 domains of education, economic stability, social context, neighborhood environment and healthcare access. Incident aTRH was defined as systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg, systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg for those with diabetes or chronic kidney disease, while taking ≥3 classes of antihypertensive medication or taking ≥4 classes of antihypertensive medication regardless of BP level, at a follow-up visit. Results: Over a median 9.5 years of follow-up, 16.1% of White versus 23.7% of Black adults developed aTRH. After age and sex adjustment, the SDOH associated with incident aTRH (hazard ratio; 95% CI) included having less than a high school education (1.51; 1.22 - 1.87), being a high school graduate (1.30; 1.10 - 1.53), and attending some college (1.29; 1.10 - 1.52) versus college graduate; annual household income 〈 $20,000 (1.83; 1.46 - 2.30), $20,000 to 〈 $35,000 (1.53; 1.23 - 1.90) and $35,000 to 〈 $75,000 (1.24; 1.00 - 1.53) versus ≥$75,000; having no one to care for you if ill (1.29; 1.08 - 1.55); living in a disadvantaged neighborhood in quartiles 1 (1.72; 1.42 - 2.08) and 2 (1.48; 1.22 - 1.80) versus 4, or a high poverty zip code (1.26; 1.09 - 1.47); not having health insurance (1.36; 1.06 - 1.74) and residing in a state with low public health infrastructure (1.17; 1.02 - 1.33). Results stratified by race are presented in the Table. Conclusion: SDOH were associated with transitioning from controlled BP to incident aTRH among White and Black adults.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.147.suppl_1.59
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 1466401-X
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  • 2
    Online Resource
    Online Resource
    Abstract 052: Social Determinants Of Health And Uncontrolled Blood Pressure In A National Cohort Of Black And White US Adults
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation Vol. 145, No. Suppl_1 ( 2022-03)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 145, No. Suppl_1 ( 2022-03)
    Abstract: Background: Hypertension and uncontrolled blood pressure (BP) are the largest contributors to racial disparities in life expectancy. Determining the contribution of social determinants of health (SDOH) to racial differences in uncontrolled BP could help identify ways to achieve the American Heart Association’s 2030 impact goal of equitably improving healthy life expectancy. Methods: We analyzed data from 7,497 Black and 7,306 White US adults taking antihypertensive medication from the REasons for Geographic and Racial Differences in Stroke study to determine the association between SDOH and uncontrolled BP. SDOH were defined using the Healthy People 2030 domains of education, economic stability, social context, neighborhood environment and healthcare access. Uncontrolled BP was defined as systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg. Results: Among participants taking antihypertensive medication (mean age 66.3 years, 50.7% Black, 57.1% female), 68.0% of Black and 59.0% of White participants had uncontrolled BP. After multivariable adjustment, uncontrolled BP (prevalence ratio; 95% CI) was more common among those with less than a high school education (1.06; 1.02 – 1.09), annual household income 〈 $20,000 (1.12; 1.06 – 1.18) and $20,000 to 〈 $35,000 (1.09; 1.04 – 1.15) versus ≥$75,000; without health insurance (1.08; 1.03 – 1.14) and residing in a disadvantaged neighborhood (1.04; 1.01 – 1.07), a zip code with high poverty (1.03; 1.00 – 1.07) or a health professional shortage area (1.07; 1.05 – 1.10). For each SDOH, the proportion of participants with uncontrolled BP was higher among Black compared with White adults. After multivariable adjustment, having a higher number of adverse SDOH was associated with a higher prevalence of uncontrolled BP among both Black and White adults (Table). Conclusion: SDOH were associated with uncontrolled BP among both Black and White adults taking antihypertensive medication.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.145.suppl_1.052
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
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  • 3
    Online Resource
    Online Resource
    Abstract P258: Global Stress and Masked Hypertension in African-Americans: The Jackson Heart Study
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Circulation Vol. 147, No. Suppl_1 ( 2023-02-28)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 147, No. Suppl_1 ( 2023-02-28)
    Abstract: Background: Chronic stress experienced at home or work has been associated with acute increases in blood pressure (BP) measured in the doctor’s office, but few data are available on the association of chronic stress with BP measured outside of the office setting. Methods: We analyzed data from 473 African-American adults enrolled in the Jackson Heart Study with office BP 〈 130/80 mm Hg to examine the association between chronic stress and masked hypertension (MHT). Chronic stress related to jobs, relationships, neighborhoods, caregiving, legal problems, medical problems, racism and discrimination, and meeting basic needs experienced over the previous 12 months was assessed using the 8-item Global Perceived Stress Scale (GPSS). We grouped participants by tertile of the composite GPSS score. Any MHT was defined as awake BP ≥ 130/80 mm Hg, asleep BP ≥ 110/65 mm Hg, or 24-hour BP ≥ 125/75 mm Hg. Analyses were stratified by antihypertensive medication use. Results: Among participants not taking antihypertensive medication (mean age 53 years), the prevalence of any MHT was 59.0%, 75.0% and 61.8% for the low (GPSS score ≤ 3), middle (GPSS score 4 - 6), and upper tertiles of the GPSS score (GPSS score 〉 6), respectively. Among those taking antihypertensive medication (mean age 61 years), the prevalence of any MHT was 77.4%, 80.7%, and 77.9% for participants in the low, middle, and upper tertile of the GPSS score, respectively. After multivariable adjustment, the prevalence ratio (95% confidence interval) for any MHT associated with the middle and upper versus low tertile of the GPSS score was 1.23 (0.96, 1.57) and 1.07 (0.83, 1.39), respectively, among those not taking antihypertensive medication and 0.97 (0.82, 1.14) and 1.02 (0.85, 1.21), respectively, among those taking antihypertensive medication (Table). Conclusion: No association was present between chronic stress and MHT among African Americans in the Jackson Heart Study.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.147.suppl_1.P258
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
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    Online Resource
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