Association Between High Perceived Stress Over Time and Incident Hypertension in Black Adults: Findings From the Jackson Heart Study

Background Chronic psychological stress has been associated with hypertension, but few studies have examined this relationship in blacks. We examined the association between perceived stress levels assessed annually for up to 13 years and incident hypertension in the Jackson Heart Study, a community...

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Published in:	Journal of the American Heart Association Vol. 8; no. 21; p. e012139
Main Authors:	Spruill, Tanya M., Butler, Mark J., Thomas, S. Justin, Tajeu, Gabriel S., Kalinowski, Jolaade, Castañeda, Sheila F., Langford, Aisha T., Abdalla, Marwah, Blackshear, Chad, Allison, Matthew, Ogedegbe, Gbenga, Sims, Mario, Shimbo, Daichi
Format:	Journal Article
Language:	English
Published:	England John Wiley and Sons Inc 05.11.2019 Wiley
Subjects:	Adult African Americans Blacks blood pressure chronic stress Diagnostic Self Evaluation Female Humans hypertension Hypertension - epidemiology Hypertension - etiology Incidence Jackson Heart Study Longitudinal Studies Male Middle Aged Original Research Stress, Psychological - complications Stress, Psychological - diagnosis Time Factors Jackson Heart Study blood pressure Blacks chronic stress hypertension
ISSN:	2047-9980, 2047-9980
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Abstract	Background Chronic psychological stress has been associated with hypertension, but few studies have examined this relationship in blacks. We examined the association between perceived stress levels assessed annually for up to 13 years and incident hypertension in the Jackson Heart Study, a community-based cohort of blacks. Methods and Results Analyses included 1829 participants without hypertension at baseline (Exam 1, 2000-2004). Incident hypertension was defined as blood pressure≥140/90 mm Hg or antihypertensive medication use at Exam 2 (2005-2008) or Exam 3 (2009-2012). Each follow-up interval at risk of hypertension was categorized as low, moderate, or high perceived stress based on the number of annual assessments between exams in which participants reported "a lot" or "extreme" stress over the previous year (low, 0 high stress ratings; moderate, 1 high stress rating; high, ≥2 high stress ratings). During follow-up (median, 7.0 years), hypertension incidence was 48.5%. Hypertension developed in 30.6% of intervals with low perceived stress, 34.6% of intervals with moderate perceived stress, and 38.2% of intervals with high perceived stress. Age-, sex-, and time-adjusted risk ratios (95% CI) associated with moderate and high perceived stress versus low perceived stress were 1.19 (1.04-1.37) and 1.37 (1.20-1.57), respectively ( trend<0.001). The association was present after adjustment for demographic, clinical, and behavioral factors and baseline stress ( trend=0.001). Conclusions In a community-based cohort of blacks, higher perceived stress over time was associated with an increased risk of developing hypertension. Evaluating stress levels over time and intervening when high perceived stress is persistent may reduce hypertension risk.
AbstractList	Background Chronic psychological stress has been associated with hypertension, but few studies have examined this relationship in blacks. We examined the association between perceived stress levels assessed annually for up to 13 years and incident hypertension in the Jackson Heart Study, a community-based cohort of blacks. Methods and Results Analyses included 1829 participants without hypertension at baseline (Exam 1, 2000-2004). Incident hypertension was defined as blood pressure≥140/90 mm Hg or antihypertensive medication use at Exam 2 (2005-2008) or Exam 3 (2009-2012). Each follow-up interval at risk of hypertension was categorized as low, moderate, or high perceived stress based on the number of annual assessments between exams in which participants reported "a lot" or "extreme" stress over the previous year (low, 0 high stress ratings; moderate, 1 high stress rating; high, ≥2 high stress ratings). During follow-up (median, 7.0 years), hypertension incidence was 48.5%. Hypertension developed in 30.6% of intervals with low perceived stress, 34.6% of intervals with moderate perceived stress, and 38.2% of intervals with high perceived stress. Age-, sex-, and time-adjusted risk ratios (95% CI) associated with moderate and high perceived stress versus low perceived stress were 1.19 (1.04-1.37) and 1.37 (1.20-1.57), respectively ( trend<0.001). The association was present after adjustment for demographic, clinical, and behavioral factors and baseline stress ( trend=0.001). Conclusions In a community-based cohort of blacks, higher perceived stress over time was associated with an increased risk of developing hypertension. Evaluating stress levels over time and intervening when high perceived stress is persistent may reduce hypertension risk. Background Chronic psychological stress has been associated with hypertension, but few studies have examined this relationship in blacks. We examined the association between perceived stress levels assessed annually for up to 13 years and incident hypertension in the Jackson Heart Study, a community-based cohort of blacks. Methods and Results Analyses included 1829 participants without hypertension at baseline (Exam 1, 2000-2004). Incident hypertension was defined as blood pressure≥140/90 mm Hg or antihypertensive medication use at Exam 2 (2005-2008) or Exam 3 (2009-2012). Each follow-up interval at risk of hypertension was categorized as low, moderate, or high perceived stress based on the number of annual assessments between exams in which participants reported "a lot" or "extreme" stress over the previous year (low, 0 high stress ratings; moderate, 1 high stress rating; high, ≥2 high stress ratings). During follow-up (median, 7.0 years), hypertension incidence was 48.5%. Hypertension developed in 30.6% of intervals with low perceived stress, 34.6% of intervals with moderate perceived stress, and 38.2% of intervals with high perceived stress. Age-, sex-, and time-adjusted risk ratios (95% CI) associated with moderate and high perceived stress versus low perceived stress were 1.19 (1.04-1.37) and 1.37 (1.20-1.57), respectively (P trend<0.001). The association was present after adjustment for demographic, clinical, and behavioral factors and baseline stress (P trend=0.001). Conclusions In a community-based cohort of blacks, higher perceived stress over time was associated with an increased risk of developing hypertension. Evaluating stress levels over time and intervening when high perceived stress is persistent may reduce hypertension risk.Background Chronic psychological stress has been associated with hypertension, but few studies have examined this relationship in blacks. We examined the association between perceived stress levels assessed annually for up to 13 years and incident hypertension in the Jackson Heart Study, a community-based cohort of blacks. Methods and Results Analyses included 1829 participants without hypertension at baseline (Exam 1, 2000-2004). Incident hypertension was defined as blood pressure≥140/90 mm Hg or antihypertensive medication use at Exam 2 (2005-2008) or Exam 3 (2009-2012). Each follow-up interval at risk of hypertension was categorized as low, moderate, or high perceived stress based on the number of annual assessments between exams in which participants reported "a lot" or "extreme" stress over the previous year (low, 0 high stress ratings; moderate, 1 high stress rating; high, ≥2 high stress ratings). During follow-up (median, 7.0 years), hypertension incidence was 48.5%. Hypertension developed in 30.6% of intervals with low perceived stress, 34.6% of intervals with moderate perceived stress, and 38.2% of intervals with high perceived stress. Age-, sex-, and time-adjusted risk ratios (95% CI) associated with moderate and high perceived stress versus low perceived stress were 1.19 (1.04-1.37) and 1.37 (1.20-1.57), respectively (P trend<0.001). The association was present after adjustment for demographic, clinical, and behavioral factors and baseline stress (P trend=0.001). Conclusions In a community-based cohort of blacks, higher perceived stress over time was associated with an increased risk of developing hypertension. Evaluating stress levels over time and intervening when high perceived stress is persistent may reduce hypertension risk. Background Chronic psychological stress has been associated with hypertension, but few studies have examined this relationship in blacks. We examined the association between perceived stress levels assessed annually for up to 13 years and incident hypertension in the Jackson Heart Study, a community‐based cohort of blacks. Methods and Results Analyses included 1829 participants without hypertension at baseline (Exam 1, 2000–2004). Incident hypertension was defined as blood pressure≥140/90 mm Hg or antihypertensive medication use at Exam 2 (2005–2008) or Exam 3 (2009–2012). Each follow‐up interval at risk of hypertension was categorized as low, moderate, or high perceived stress based on the number of annual assessments between exams in which participants reported “a lot” or “extreme” stress over the previous year (low, 0 high stress ratings; moderate, 1 high stress rating; high, ≥2 high stress ratings). During follow‐up (median, 7.0 years), hypertension incidence was 48.5%. Hypertension developed in 30.6% of intervals with low perceived stress, 34.6% of intervals with moderate perceived stress, and 38.2% of intervals with high perceived stress. Age‐, sex‐, and time‐adjusted risk ratios (95% CI) associated with moderate and high perceived stress versus low perceived stress were 1.19 (1.04–1.37) and 1.37 (1.20–1.57), respectively (P trend<0.001). The association was present after adjustment for demographic, clinical, and behavioral factors and baseline stress (P trend=0.001). Conclusions In a community‐based cohort of blacks, higher perceived stress over time was associated with an increased risk of developing hypertension. Evaluating stress levels over time and intervening when high perceived stress is persistent may reduce hypertension risk.
Author	Shimbo, Daichi Thomas, S. Justin Tajeu, Gabriel S. Ogedegbe, Gbenga Spruill, Tanya M. Kalinowski, Jolaade Sims, Mario Castañeda, Sheila F. Abdalla, Marwah Blackshear, Chad Allison, Matthew Butler, Mark J. Langford, Aisha T.
AuthorAffiliation	7 Department of Family Medicine and Public Health University of California at San Diego CA 8 Department of Medicine University of Mississippi Medical Center Jackson MS 3 Department of Health Services Administration and Policy Temple University Philadelphia PA 4 Graduate School of Public Health San Diego State University San Diego CA 5 Department of Medicine Columbia University Medical Center New York NY 1 Department of Population Health New York University School of Medicine New York NY 6 Department of Data Science University of Mississippi Medical Center Jackson MS 2 Department of Psychiatry University of Alabama at Birmingham AL
AuthorAffiliation_xml	– name: 8 Department of Medicine University of Mississippi Medical Center Jackson MS – name: 5 Department of Medicine Columbia University Medical Center New York NY – name: 3 Department of Health Services Administration and Policy Temple University Philadelphia PA – name: 6 Department of Data Science University of Mississippi Medical Center Jackson MS – name: 7 Department of Family Medicine and Public Health University of California at San Diego CA – name: 2 Department of Psychiatry University of Alabama at Birmingham AL – name: 1 Department of Population Health New York University School of Medicine New York NY – name: 4 Graduate School of Public Health San Diego State University San Diego CA
Author_xml	– sequence: 1 givenname: Tanya M. surname: Spruill fullname: Spruill, Tanya M. organization: Department of Population Health New York University School of Medicine New York NY – sequence: 2 givenname: Mark J. surname: Butler fullname: Butler, Mark J. organization: Department of Population Health New York University School of Medicine New York NY – sequence: 3 givenname: S. Justin surname: Thomas fullname: Thomas, S. Justin organization: Department of Psychiatry University of Alabama at Birmingham AL – sequence: 4 givenname: Gabriel S. surname: Tajeu fullname: Tajeu, Gabriel S. organization: Department of Health Services Administration and Policy Temple University Philadelphia PA – sequence: 5 givenname: Jolaade surname: Kalinowski fullname: Kalinowski, Jolaade organization: Department of Population Health New York University School of Medicine New York NY – sequence: 6 givenname: Sheila F. surname: Castañeda fullname: Castañeda, Sheila F. organization: Graduate School of Public Health San Diego State University San Diego CA – sequence: 7 givenname: Aisha T. surname: Langford fullname: Langford, Aisha T. organization: Department of Population Health New York University School of Medicine New York NY – sequence: 8 givenname: Marwah surname: Abdalla fullname: Abdalla, Marwah organization: Department of Medicine Columbia University Medical Center New York NY – sequence: 9 givenname: Chad surname: Blackshear fullname: Blackshear, Chad organization: Department of Data Science University of Mississippi Medical Center Jackson MS – sequence: 10 givenname: Matthew surname: Allison fullname: Allison, Matthew organization: Department of Family Medicine and Public Health University of California at San Diego CA – sequence: 11 givenname: Gbenga surname: Ogedegbe fullname: Ogedegbe, Gbenga organization: Department of Population Health New York University School of Medicine New York NY – sequence: 12 givenname: Mario surname: Sims fullname: Sims, Mario organization: Department of Medicine University of Mississippi Medical Center Jackson MS – sequence: 13 givenname: Daichi surname: Shimbo fullname: Shimbo, Daichi organization: Department of Medicine Columbia University Medical Center New York NY
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/31615321$$D View this record in MEDLINE/PubMed
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Copyright	2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
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Notes	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 A subset of the data contained in this article was presented at the American Heart Association Epi/Lifestyle Scientific Sessions, March 20 to 23, 2018, in New Orleans, LA.
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Snippet	Background Chronic psychological stress has been associated with hypertension, but few studies have examined this relationship in blacks. We examined the...
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SubjectTerms	Adult African Americans Blacks blood pressure chronic stress Diagnostic Self Evaluation Female Humans hypertension Hypertension - epidemiology Hypertension - etiology Incidence Jackson Heart Study Longitudinal Studies Male Middle Aged Original Research Stress, Psychological - complications Stress, Psychological - diagnosis Time Factors
Title	Association Between High Perceived Stress Over Time and Incident Hypertension in Black Adults: Findings From the Jackson Heart Study
URI	https://www.ncbi.nlm.nih.gov/pubmed/31615321 https://www.proquest.com/docview/2306212800 https://pubmed.ncbi.nlm.nih.gov/PMC6898810 https://doaj.org/article/240e936ca5d94acc9b2f6d64f96d986b
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