|Title||Late life socioeconomic status and hypertension in an aging cohort: the Atherosclerosis Risk in Communities Study.|
|Publication Type||Journal Article|
|Year of Publication||2018|
|Authors||M McDoom M, Palta P, Vart P, Juraschek SP, Kucharska-Newton AMaria, Diez Roux AV|
|Secondary Authors||Coresh JJ|
|Date Published||2018 06|
|Keywords||Aged, Atherosclerosis, Cross-Sectional Studies, Humans, Hypertension, Middle Aged, Proportional Hazards Models, Risk Factors, Social Class|
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.
|Alternate Journal||J Hypertens|
|PubMed Central ID||PMC6453664|
|Grant List||R01 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