title: Psychosocial Factors Are Associated With Blood Pressure Progression Among African Americans in the Jackson Heart Study.
abstract: Research that examines the associations of psychosocial factors with incident hypertension among African Americans (AA) is limited. Using Jackson Heart Study (JHS) data, we examined associations of negative affect and stress with incident hypertension and blood pressure (BP) progression among AA.
  
  
  
  Our sample consisted of 1,656 normotensive participants at baseline (2000-2004) (mean age 47±12; 61% women). We investigated associations of negative affect (cynical distrust, anger-in, anger-out, and depressive symptoms) and stress (perceived stress, weekly stress inventory (WSI)-event, WSI-impact, and major life events) with BP progression (an increase by one BP stage as defined by JNC VII) and incident hypertension by examination 2 (2005-2008). Poisson regression analysis was utilized to examine the prevalence ratios (PRs; 95% confidence interval (CI)) of BP tracking and incident hypertension with psychosocial factors, adjusting for baseline age, sex, socioeconomic status (SES), and hypertension risk factors.
  
  
  
  Fifty-six percentage of the sample (922 cases) had BP progression from 2005 to 2008. After adjustment for age, sex, and SES, a high anger-out score was associated with a 20% increased risk of BP progression compared to a low anger-out score (PR 1.20; 95% CI 1.05-1.36). High depressive symptoms score was associated with BP progression in the age, sex, and SES-adjusted model (PR 1.14; 95% CI 1.00-1.30). High WSI-event scores were associated with BP progression in the fully adjusted model (PR 1.21; 95% CI 1.04-1.40). We did not observe significant associations with any of the psychosocial measures and incident hypertension.
  
  
  
  Psychosocial factors were associated with BP progression, with the strongest evidence for number of stressful events that occurred.
authors.affiliation: Capstone College of Nursing, The University of Alabama, Tuscaloosa, Alabama, USA; ford039@ua.edu.
authors.forename: Cassandra D
authors.initials: CD
authors.lastname: Ford
authors.affiliation: Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA;
authors.forename: Mario
authors.initials: M
authors.lastname: Sims
authors.affiliation: College of Community Health Sciences, The University of Alabama, Tuscaloosa, Alabama, USA;
authors.forename: John C
authors.initials: JC
authors.lastname: Higginbotham
authors.affiliation: Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA;
authors.forename: Martha R
authors.initials: MR
authors.lastname: Crowther
authors.affiliation: Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA; School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA;
authors.forename: Sharon B
authors.initials: SB
authors.lastname: Wyatt
authors.affiliation: Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA;
authors.forename: Solomon K
authors.initials: SK
authors.lastname: Musani
authors.affiliation: Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, Mississippi, USA;
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Payne
authors.affiliation: Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA;
authors.forename: Ervin R
authors.initials: ER
authors.lastname: Fox
authors.affiliation: Culverhouse College of Commerce and Business Administration, The University of Alabama, Tuscaloosa, Alabama, USA.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Parton
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology*; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological / Q000503:physiopathology*; D055815:Young Adult
keywords: African Americans; Jackson Heart Study; blood pressure; health disparities; hypertension; psychosocial.