title: African Ancestry, Social Factors, and Hypertension Among Non-Hispanic Blacks in the Health and Retirement Study.
abstract: The biomedical literature contains much speculation about possible genetic explanations for the large and persistent black-white disparities in hypertension, but profound social inequalities are also hypothesized to contribute to this outcome. Our goal is to evaluate whether socioeconomic status (SES) differences provide a plausible mechanism for associations between African ancestry and hypertension in a U.S. cohort of older non-Hispanic blacks. We included only non-Hispanic black participants (N = 998) from the Health and Retirement Study who provided genetic data. We estimated percent African ancestry based on 84,075 independent single nucleotide polymorphisms using ADMIXTURE V1.23, imposing K = 4 ancestral populations, and categorized into quartiles. Hypertension status was self-reported in the year 2000. We used linear probability models (adjusted for age, sex, and southern birth) to predict prevalent hypertension with African ancestry quartile, before and after accounting for a small set of SES measures. Respondents with the highest quartile of African ancestry had 8 percentage points' (RD = 0.081; 95% CI: -0.001, 0.164) higher prevalence of hypertension compared to the lowest quartile. Adjustment for childhood disadvantage, education, income, and wealth explained over one-third (RD = 0.050; 95% CI: -0.034, 0.135) of the disparity. Explanations for the residual disparity remain unspecified and may include other indicators of SES or diet, lifestyle, and psychosocial mechanisms.
authors.affiliation: a Department of Social and Behavioral Sciences , Harvard School of Public Health , Boston , Massachusetts , USA.
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Marden
authors.affiliation: b Department of Epidemiology and Biostatistics , University of California at San Francisco , San Francisco , California , USA.
authors.forename: Stefan
authors.initials: S
authors.lastname: Walter
authors.affiliation: c Department of Epidemiology and Biostatistics , McGill University , Montreal , Quebec , Canada.
authors.forename: Jay S
authors.initials: JS
authors.lastname: Kaufman
authors.affiliation: a Department of Social and Behavioral Sciences , Harvard School of Public Health , Boston , Massachusetts , USA.|b Department of Epidemiology and Biostatistics , University of California at San Francisco , San Francisco , California , USA.
authors.forename: M Maria
authors.initials: MM
authors.lastname: Glymour
mesh_terms: D001741:Black or African American / Q000235:genetics / Q000706:statistics & numerical data*; D000368:Aged; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology / Q000235:genetics; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology