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Late life socioeconomic status and hypertension in an aging cohort: the Atherosclerosis Risk in Communities Study.

TitleLate life socioeconomic status and hypertension in an aging cohort: the Atherosclerosis Risk in Communities Study.
Publication TypeJournal Article
Year of Publication2018
AuthorsM McDoom M, Palta P, Vart P, Juraschek SP, Kucharska-Newton AMaria, Diez Roux AV
Secondary AuthorsCoresh JJ
JournalJ Hypertens
Volume36
Issue6
Pagination1382-1390
Date Published2018 06
ISSN1473-5598
KeywordsAged, Atherosclerosis, Cross-Sectional Studies, Humans, Hypertension, Middle Aged, Proportional Hazards Models, Risk Factors, Social Class
Abstract

OBJECTIVE: To investigate the association between individual and area-level socioeconomic status and hypertension risk among individuals later in life.

METHODS: We used Cox proportional hazards models to examine the association of socioeconomic status with incident hypertension using race-specific neighborhood socioeconomic status, median household income, and education among 3372 participants (mean age, 61 years) from the Atherosclerosis Risk in Communities Study at Visit 4 (1996-1998). Incident hypertension was defined as self-reported diagnosis or reported use of antihypertensive medications.

RESULTS: Over a median follow-up time of 9.4 years, there were 1874 new cases of hypertension (62.1 per 1000 person-years). Overall, being in high as compared with low socioeconomic status categories was associated with a lower risk of developing hypertension in late life, with hazard ratios (95% confidence intervals) of 0.87 (0.77-0.98) for high neighborhood socioeconomic status tertile, 0.79 (0.69-0.90) for high individual income, and 0.75 (0.63-0.89) for college education after adjustment for traditional risk factors. These findings were consistent and robust whenever accounting for competing risks of all-cause mortality. No significant interactions by race and age (dichotomized at age 65) were observed.

CONCLUSION: Among participants free of hypertension in midlife, high neighborhood and individual socioeconomic status are associated with a decreased risk of incident hypertension. Our findings support population-level interventions, such as blood pressure screening at senior centers and faith-based organizations, that are tailored to shift the distribution of blood pressure and reduce hypertension health inequalities among older adults.

DOI10.1097/HJH.0000000000001696
Alternate JournalJ Hypertens
PubMed ID29621068
PubMed Central IDPMC6453664
Grant ListR01 HL064142 / HL / NHLBI NIH HHS / United States
T32 DK007732 / DK / NIDDK NIH HHS / United States
T32 HL007024 / HL / NHLBI NIH HHS / United States
HHSN268201700001I / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
HHSN268201000021C / HL / NHLBI NIH HHS / United States
K23 HL135273 / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
T32 HL007055 / HL / NHLBI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States
K99 AG052830 / AG / NIA NIH HHS / United States