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

M. Maya McDoom, Priya Palta, Priya Vart, Stephen P. Juraschek, Anna Kucharska-Newton, Ana V. Diez Roux, Josef Coresh

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

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.

Original languageEnglish
Pages (from-to)1382-1390
Number of pages9
JournalJournal of Hypertension
Volume36
Issue number6
DOIs
StatePublished - Jun 1 2018

Bibliographical note

Publisher Copyright:
Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

Keywords

  • aging
  • area level characteristics
  • blood pressure
  • hypertension
  • social environment
  • socioeconomic status

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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