CitationScott, Jewel; Silve, Susan; & Simmons, Leigh Ann (2019). Sleep characteristics and adverse social exposures elevate blood pressure in young black females. American Heart Association's Epidemiology and Prevention/Lifestyle and Cardiometabolic Health 2019 Scientific Sessions. Houston, Tx: Circulation.
Abstractntroduction: The prevalence of hypertension (HTN) in Black females is 46%, which is higher than males and other females in the United States. Among Black females, HTN develops at younger ages and often is more difficult to treat. Research suggests that sleep quality and quantity may have sex- and race-specific implications for CV health. Further, sleep characteristics may be a behavioral response to adverse social exposures (e.g., discrimination, financial stress), and this response may be amplified among young adults. Hypothesis: We assessed the hypothesis that sleep characteristics and adverse social exposures may contribute to elevated blood pressure in Black women. Methods: Participants included 634 Black females who participated in the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative study of youth in the U.S. initially enrolled between 7th-12th grades and followed over 2.5 decades. Adverse social exposures included child abuse, discrimination, perceived stress, social isolation, and subjective social status. Self-reported sleep characteristics included measures of duration, latency, continuity, and snoring. Applying 2018 AHA guidelines, participants were classified as having elevated BP (>120/80) or not in early adulthood (age 24-32 years). Bivariate and multivariable logistic regression was used to evaluate the influence of social exposures, sleep characteristics, and their interactions on elevated BP. Results: Despite a mean age of 28.9 years, 58% (374 of 634) of the sample had elevated BP. In bivariate analyses, lack of sleep continuity, snoring, less social isolation, and less perceived stress predicted elevated BP, but sleep duration and latency did not. Multivariable analyses that adjusted for demographics, BMI, and depression indicated that elevated BP was associated with snoring (OR 1.458, p=0.03), frequent awakening (OR 1.904, p=0.0005), less social isolation (OR 0.691, p=0.05), and lower perceived stress (OR 0.646, p=0.02). Interactions between sleep characteristics and social exposures were insignificant in predicting elevated BP. Conclusions: Sleep characteristics may represent a key risk factor for HTN that could be addressed in targeted interventions beginning in adolescence. Given the unexpected inverse relationship between social isolation, perceived stress, and elevated BP, future research should examine how current paradigms and measures of social connectedness and stress may need to be adapted to better elucidate the impact of these factors on Black women’s long-term CV health.
Reference TypeConference proceeding
Book TitleAmerican Heart Association's Epidemiology and Prevention/Lifestyle and Cardiometabolic Health 2019 Scientific Sessions
Simmons, Leigh Ann