Systolic Blood Pressure and Socioeconomic Status in a large multi-study population.

Abstract

The present study used harmonized data from eight studies (N = 28,891) to examine the association between socioeconomic status (SES) and resting systolic blood pressure (SBP). The study replicates and extends our prior work on this topic by examining potential moderation of this association by race and gender. We also examined the extent to which body mass index (BMI), waist circumference (WC), and smoking might explain the association between SES and SBP. Data were available from six race/gender groups: 9200 Black women; 2337 Black men; 7248 White women; 6519 White men; 2950 Hispanic women; and 637 Hispanic men. Multivariable regression models showed that greater annual household income was associated with lower SBP in all groups except Hispanic men. The magnitude and form of this negative association differed across groups, with White women showing the strongest linear negative association. Among Black men and Hispanic women, the association was curvilinear: relatively flat among lower income levels, but then negative among higher income ranges. Education also was independently, negatively related to SBP, though evidence was weaker for race and gender differences in the strength of the association. Higher BMI and WC were associated with higher SBP, and current smoking with lower SBP. Inclusion of these risk factors resulted in only a modest change in the magnitude of the SBP and SES relation, accounting on average about 0.4 mmHg of the effect of income and 0.2 mmHg of the effect of education-effects unlikely to be clinically significant. Further understanding of mechanisms underlying the association between SBP and SES may improve risk stratification in clinical settings and potentially inform interventions aimed at reductions in social disparities in health.

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Citation

Published Version (Please cite this version)

10.1016/j.ssmph.2019.100498

Publication Info

Brummett, Beverly H, Michael A Babyak, Rong Jiang, Kim M Huffman, William E Kraus, Abanish Singh, Elizabeth R Hauser, Ilene C Siegler, et al. (2019). Systolic Blood Pressure and Socioeconomic Status in a large multi-study population. SSM - population health, 9. p. 100498. 10.1016/j.ssmph.2019.100498 Retrieved from https://hdl.handle.net/10161/23292.

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Scholars@Duke

Brummett

Beverly H. Brummett

Associate Professor Emeritus in Psychiatry and Behavioral Sciences

In the early part of my career, my work generally focused on examining psychosocial determinants or correlates (e.g., emotion, personality, and socioeconomic status) of cardiovascular disease.  However, in the past several years, my work has also expanded to include examining how stressful emotional responses, combined with proposed genetic markers, influence metabolic functioning, cognitive decline, functional capacity and quality of live in the elderly, depressive symptomology, and major depressive disorder.  I also have an interest in statistical methodology. 

Babyak

Michael Alan Babyak

Professor Emeritus in Psychiatry and Behavioral Sciences

Since coming to Duke as an intern in 1994 I have collaborated as a biostatistician and co-investigator at Duke on numerous observational and experimental studies involving behavior, psychosocial factors, health, and disease. The substantive topics have ranged across questions concerning exercise and depression, hypertension, weight loss, the genetics of stress and heart disease, sickle cell disease, to name a few. I am particularly interested in the issue of improving reproducibility and transparency in data analysis.

Jiang

Rong Jiang

Assistant Professor in Head and Neck Surgery & Communication Sciences

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