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Association of Net Worth and Ambulatory Blood Pressure in Early Middle-aged African American Women
Journal article   Open access   Peer reviewed

Association of Net Worth and Ambulatory Blood Pressure in Early Middle-aged African American Women

Telisa Spikes, Raphiel Murden, Izraelle I McKinnon, Samantha Bromfield, Miriam E Van Dyke, Renee H Moore, Frederic F Rahbari-Oskoui, Arshed Quyummi, Viola Vaccarino and Tené T Lewis
JAMA network open, v 5(2), pp e220331-e220331
01 Feb 2022
DOI: https://doi.org/10.1001/jamanetworkopen.2022.0331
PMID: 35201307
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1001/jamanetworkopen.2022.0331View
Published, Version of Record (VoR)CC BY-NC-ND V4.0,  Open

Abstract

Adult African Americans - statistics & numerical data Blood Pressure - physiology Blood Pressure Monitoring, Ambulatory Cross-Sectional Studies Female Financial Statements - statistics & numerical data Humans Hypertension - epidemiology Middle Aged
Low socioeconomic status (SES) in the form of educational level and income has been linked to greater cardiovascular risk across cohorts; however, associations have been inconsistent for African American individuals. Net worth, a measure of overall assets, may be a more relevant metric, especially for African American women, because it captures longer-term financial stability and economic reserve. To examine whether net worth is associated with increased ambulatory blood pressure (ABP), a marker of cardiovascular disease (CVD) risk, independent of educational level and income, in young to middle-aged African American women. A cross-sectional, community-based study conducted in the southeastern US was performed using 48-hour ambulatory BP monitoring. Participants included 384 African American women aged 30 to 46 years without clinical CVD recruited between December 16, 2016, and March 21, 2019; data analysis was performed from September 2020 to December 2021. Self-reported net worth (total financial assets minus debts), self-reported educational level, and self-reported income. Mean daytime and nighttime BP levels, assessed via 48-hour ABP monitoring and sustained hypertension (ABP daytime and clinic BP ≥130/80 mm Hg). The 384 African American women in this study represented a range of SES backgrounds; mean (SD) age was 38.0 (4.3) years. Excluding 66 women who were not receiving antihypertensive medications, in linear regression models adjusted for age, marital status, educational level, family income, and family size, women reporting a negative net worth (debt) had higher levels of daytime (β = 6.7; SE = 1.5; P < .001) and nighttime (β = 6.4; SE = 1.4; P < .001) systolic BP, compared with women reporting a positive net worth. Similar associations were observed with sustained hypertension: women reporting a negative net worth had 150% higher odds (odds ratio, 2.5; 95% CI, 1.3-4.7) of sustained hypertension than those reporting a positive net worth. Associations remained significant after additional adjustments for smoking, body mass index, psychosocial stress due to debt, and depressive symptoms and were similar, although attenuated, when women receiving antihypertensive medications were included and treatment was controlled for in all analyses. In this cross-sectional study, having a negative net worth (ie, debt) was associated with elevated BP in African American women, independent of traditional indicators of SES. This finding suggests that limited assets or a lack of economic reserve may be associated with poor CVD outcomes in this at-risk group.

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17 Record Views
13 citations in Web of Science
15 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being
#10 Reduced Inequalities

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Collaboration types
Domestic collaboration
Web of Science research areas
Peripheral Vascular Disease
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