Social, behavioral and anthropometric predictors of changes in blood pressure in African-Americans: The Pitt County Study.

Blacks have approximately twice the risk of hypertension as their whites counterparts. The reasons for this excess risk among African Americans remain unclear. This study is a five year (1988-1993) longitudinal investigation of the influence of social, behavioral and anthropometric risk factors on changes in blood pressure (BP) among African American participants, ages 25-50, in the Pitt County (NC) Study. Specifically, contributions of alcohol consumption, obesity and weight gain, and instrumental social support (i.e. availability of tangible aid from others) to hypertension risk were examined in three separate papers. Associations were examined through the use of multiple logistic and linear regression techniques. Each paper investigated the role of the baseline exposure as well as five year changes in exposure status. Findings from the first paper indicate that change in alcohol consumption status, but not baseline consumption, was significantly associated with changes in mean systolic blood pressure (SBP). That is, persons initiating drinking by 1993 had a 6.2 mmHg greater increase in SBP compared to never drinkers, while continued drinkers had a 3.8 mmHg greater increase compared to never drinkers. The results for diastolic blood pressure (DBP) and hypertension incidence were in the same direction, but not statistically significant. The second paper determined that both baseline BMI and weight change were positively and independently associated with changes in mean BP; these associations were stronger for men. After participants were stratified by overweight/non-overweight status at baseline, weight change was significantly associated with elevated BP only among the initially non-overweight. After stratification, the strength of the latter association was similar for men and women. The third paper documented that increases in instrumental support over baseline values were associated with smaller changes in BP for women and married men. Importantly, all three categories of risk factors (alcohol consumption, body weight, and instrumental support) are modifiable through both individual and community level interventions, and such interventions are encouraged in order to promote improved cardiovascular health in African American communities.Ph.D.Health and Environmental SciencesPathologyPublic healthUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/130453/2/9732062.pd