Association between neighborhood-level socioeconomic deprivation and incident hypertension: A longitudinal analysis of data from the Dallas heart study

Background: Although neighborhood-level socioeconomic deprivation associates with prevalent obesity, its relationship to individual-level weight change over time is poorly elucidated. Few studies have evaluated the impact of behavioral and psychosocial factors on this relationship. Methods: We examined the relationship between neighborhood-level socioeconomic deprivation and weight change among those who did not move in the 7-year study period (N=955) of the Dallas Heart Study (DHS), a multi-ethnic, population-based sample of Dallas County residents aged 18-65. Baseline weight measurements were performed in 2000-02 and weight was re-measured at 7-year follow-up. Home addresses obtained at baseline and follow-up were geocoded and linked to residential census tracts in Dallas County. A neighborhood deprivation index (NDI) for DHS participants was created using factor analysis of 21 census-tract neighborhood characteristics, with higher scores indicating more socioeconomic deprivation. Repeated-measures linear mixed modeling with random effects was used to determine weight change (kg) relative to tertiles of NDI. Reported physical activity (yes/no: exercised <150 mets/min-wk) and perceptions of neighborhood environment (questionnaire-derived score with higher score = more unfavorable perceptions of neighborhood violence, aesthetics, and social cohesion) were examined as mediators. Results: DHS participants living in more socioeconomically deprived neighborhoods had lower income and education (p-trend <0.001 for both). Blacks were more likely to live in more socioeconomically deprived neighborhoods than whites and Hispanics (p<0.001). Adjusting for age, sex, race, smoking, education, and income as fixed effects, DHS participants living in the most socioeconomically deprived neighborhoods (highest NDI tertile) gained 5.8±2.5 more kilograms (p=0.02) over the 7-year period compared to those in the least deprived neighborhoods. Living in the most socioeconomically deprived neighborhoods remained associated with a 6.4±2.5 kg greater increase in weight (p=0.01) compared to living in the least deprived neighborhoods after adjustment for physical activity levels and a 6.6±2.6 kg greater increase in weight (p=0.01) after adjustment for perceptions of neighborhood environment. Conclusions: Living in more socioeconomically deprived neighborhoods is associated with greater weight gain among DHS participants over a 7-year period. This relationship does not appear to be fully explained by lower levels of physical activity or unfavorable perceptions of the neighborhood environment. In Dallas County, the high risk for greater weight gain among people living in socioeconomically deprived neighborhoods supports the need to develop targeted community-based interventions to address obesity and reduce disparities in cardiovascular risk.

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Abstract P151: Neighborhood-Level Socioeconomic Deprivation Is Associated with Diabetes Mellitus in a Multi-Ethnic Population: The Dallas Heart Study

Circulation ◽

10.1161/circ.129.suppl_1.p151 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Michael McClurkin ◽

Colby Ayers ◽

Tammy Leonard ◽

Rebecca Cooper-McCann ◽

Christine Hoehner ◽

...

Keyword(s):

Socioeconomic Deprivation ◽

Self Report ◽

Metabolic Risk Factor ◽

Metabolic Risk ◽

Ethnic Population ◽

Dallas County ◽

Heart Study ◽

Dallas Heart Study ◽

The Relationship ◽

Neighborhood Level

Background: Although neighborhood-level socioeconomic deprivation has been associated with obesity, its relationship with diabetes, a cardio-metabolic risk factor and determinant of cardiovascular health, is poorly understood. Methods and Results: We examined the relationship between neighborhood-level socioeconomic deprivation and prevalent diabetes in the Dallas Heart Study (DHS), a multi-ethnic, population-based sample of Dallas County residents aged 18-65 (N=1621). Participants underwent detailed examination between 2000-2002. Geo-coded home addresses defined neighborhood block groups; a neighborhood-level deprivation index (NDI) for Dallas County was created using factor analysis based on 21 Census block-group characteristics (higher scores=greater neighborhood-level deprivation). Diabetes was defined by self-report, use of anti-hyperglycemic medication, or fasting glucose≥126 mg/dl. Logistic regression modeling was used to determine odds of prevalent diabetes for those in highest vs. lowest NDI tertile. In DHS, diabetes prevalence was 5%, 13%, and 16% across NDI tertiles (p<0.001). In modeling diabetes, we found a significant interaction between race and NDI (p=0.03); therefore, models were race-stratified. White, Hispanic, and black DHS participants in neighborhoods in the highest NDI tertile were up to seven times more likely to have diabetes than those living in the lowest tertile (Table). In whites and Hispanics, higher deprivation remained associated with a greater likelihood of diabetes after adjustment for age, sex, smoking, and education and was only attenuated after adjusting for income. In contrast, adjustment for confounders attenuated the relationship between NDI and diabetes among blacks. Conclusions: Residing in socioeconomically deprived neighborhoods is associated with prevalent diabetes among whites and Hispanics in DHS. These data suggest racial/ethnic disparities in cardio-metabolic risk within areas of higher socioeconomic deprivation in Dallas County.

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Neighborhood-level socioeconomic deprivation predicts weight gain in a multi-ethnic population: Longitudinal data from the Dallas Heart Study

Preventive Medicine ◽

10.1016/j.ypmed.2014.05.011 ◽

2014 ◽

Vol 66 ◽

pp. 22-27 ◽

Cited By ~ 42

Author(s):

Tiffany M. Powell-Wiley ◽

Colby Ayers ◽

Priscilla Agyemang ◽

Tammy Leonard ◽

David Berrigan ◽

...

Keyword(s):

Weight Gain ◽

Longitudinal Data ◽

Socioeconomic Deprivation ◽

Ethnic Population ◽

Heart Study ◽

Dallas Heart Study ◽

Neighborhood Level

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Adiponectin predicts incident hypertension independent of body fat accumulation; observations from the dallas heart study

Journal of the American Society of Hypertension ◽

10.1016/j.jash.2016.03.164 ◽

2016 ◽

Vol 10 (4) ◽

pp. e67

Author(s):

Poghni A. Peri-Okonny ◽

Colby R. Ayers ◽

Naim Maalouf ◽

Sandeep R. Das ◽

James A. de Lemos ◽

...

Keyword(s):

Body Fat ◽

Fat Accumulation ◽

Incident Hypertension ◽

Heart Study ◽

Dallas Heart Study

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Adiponectin protects against incident hypertension independent of body fat distribution: observations from the Dallas Heart Study

Diabetes/Metabolism Research and Reviews ◽

10.1002/dmrr.2840 ◽

2016 ◽

Vol 33 (2) ◽

pp. e2840 ◽

Cited By ~ 11

Author(s):

Poghni A. Peri-Okonny ◽

Colby Ayers ◽

Naim Maalouf ◽

Sandeep R. Das ◽

James A. de Lemos ◽

...

Keyword(s):

Body Fat ◽

Fat Distribution ◽

Body Fat Distribution ◽

Incident Hypertension ◽

Heart Study ◽

Dallas Heart Study

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YIA 02-04 RELATIONSHIP BETWEEN LEPTIN AND INCIDENT HYPERTENSION; OBSERVATIONS FROM THE DALLAS HEART STUDY

Journal of Hypertension ◽

10.1097/01.hjh.0000500439.23354.a4 ◽

2016 ◽

Vol 34 (Supplement 1) ◽

pp. e203

Author(s):

Poghni Peri-Okonny ◽

Colby Ayers ◽

Naim Maalouf ◽

Sandeep Das ◽

James De Lemos ◽

...

Keyword(s):

Incident Hypertension ◽

Heart Study ◽

Dallas Heart Study

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Faculty Opinions recommendation of Sex differences in the association between leptin and CRP: results from the Dallas Heart Study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1097370.554558 ◽

2007 ◽

Author(s):

Matthew Allison

Keyword(s):

Sex Differences ◽

Heart Study ◽

Dallas Heart Study

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Sex-Specific Differences in the Association Between Obesity and Depression in Large Epidemiological Studies: Findings From Dallas Heart Study and National Health and Nutrition Examination Survey

Biological Psychiatry ◽

10.1016/j.biopsych.2021.02.849 ◽

2021 ◽

Vol 89 (9) ◽

pp. S340

Author(s):

Abu Minhajuddin ◽

Manish Jha ◽

Cherise Chin Fatt ◽

Taryn Mayes ◽

Madhukar Trivedi

Keyword(s):

National Health ◽

Epidemiological Studies ◽

Nutrition Examination Survey ◽

Health And Nutrition ◽

Heart Study ◽

Dallas Heart Study

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Association of Lipoprotein-Associated Phospholipase A2 Mass and Activity with Coronary and Aortic Atherosclerosis: Findings from the Dallas Heart Study

Clinical Chemistry ◽

10.1373/clinchem.2008.107359 ◽

2008 ◽

Vol 54 (12) ◽

pp. 1975-1981 ◽

Cited By ~ 22

Author(s):

Emmanouil S Brilakis ◽

Amit Khera ◽

Bilal Saeed ◽

Subhash Banerjee ◽

Darren K McGuire ◽

...

Keyword(s):

Phospholipase A2 ◽

Large Population ◽

Population Based ◽

Aortic Atherosclerosis ◽

Standard Deviation Increase ◽

Plaque Instability ◽

Aortic Plaque ◽

Heart Study ◽

Atherosclerosis Risk Factors ◽

Dallas Heart Study

Abstract Background: Our aim was to characterize the association of lipoprotein-associated phospholipase A2 (Lp-PLA2) with coronary and aortic atherosclerosis in a large population-based study. Methods: Lp-PLA2 mass and activity were measured in 2171 subjects 30–65 years old participating in the Dallas Heart Study. We examined the association of Lp-PLA2 levels with 3 atherosclerosis phenotypes: coronary artery calcium (CAC) measured by electron-beam computed tomography and abdominal aortic plaque (AAP) and aortic wall thickness (AWT) measured by magnetic resonance imaging. Results: CAC and AAP were detected in 21% and 40% of subjects, respectively, and mean AWT (SD) was 1.70 (0.32) mm. In univariable analyses, Lp-PLA2 mass (but not activity) was higher in both men (P = 0.04) and women (P = 0.02) with detectable CAC. Lp-PLA2 mass and activity were higher (P = 0.004 and P = 0.01, respectively) and AWT was greater (P < 0.001 and P = 0.02, respectively) in women with aortic atheroma, but not in men. After adjustment for traditional atherosclerosis risk factors and C-reactive protein concentrations, Lp-PLA2 mass and activity were not associated with AAP or AWT in either sex, but Lp-PLA2 mass remained modestly associated with detectable CAC only in men (odds ratio 1.20 per 1 standard deviation increase, 95% CI 1.01–1.42, P = 0.04). Conclusions: Although Lp-PLA2 mass was independently associated with CAC in men, it was not associated with AAP or AWT in men or with any of the atherosclerosis phenotypes in women. These findings suggest that if Lp-PLA2 independently influences clinical events, it does so by promoting atherosclerotic plaque instability rather than by stimulating atherogenesis.

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Abstract 003: Change in Cardiovascular Risk Factors Associated with Weight Gain in the Dallas Heart Study

Circulation ◽

10.1161/circ.125.suppl_10.a003 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Tiffany M Powell ◽

Colby R Ayers ◽

James A de Lemos ◽

Amit Khera ◽

Susan G Lakoski ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Weight Gain ◽

Cardiovascular Risk Factors ◽

Average Weight ◽

Men And Women ◽

Significant Weight Gain ◽

Heart Study ◽

Dallas Heart Study ◽

The Impact

Background: Concerning trends in weight gain from 2000-2009 exist in the Dallas Heart Study (DHS), a probability-based sample of Dallas County residents aged 30-65. However, the impact of significant weight gain (≥ 5% increase in body weight) on cardiovascular risk factors (CVRF) in this contemporary, multi-ethnic population is not known. Methods: We measured weight, LDL-c, blood pressure (SBP and DBP), and fasting glucose (FG) in 2,022 DHS participants (58% female) at study entry in 2000 and in 2009. Using logistic regression stratified by sex and race/ethnicity, we determined the age-adjusted odds of worsening CVRF (any increase in LDL-c, SBP, DBP or FG) for people who gained significant weight compared to those who did not. Results: Among women, 43% (N=500) gained significant weight, compared to 42% of men (N=355). Despite similar average weight gain (9.7±5.8 kg for women vs. 10±5.6 kg for men, p=0.4), women who gained significant weight had almost twice as large an increase in LDL-c (14±34 vs. 8±39 mg/dl, p=0.01) and SBP (12±18 vs. 6±19 mmHg, p<0.001) compared with men who gained significant weight. Increases in DBP (5±10 vs. 4±11 mmHg, p=0.05) and FG (4±29 vs. 2±32 mg/dl, p=0.30) were not significantly different between men and women. Among those with significant weight gain who were not on medications, SBP and LDL-c increases were higher in women compared with men (p<0.05). Differences in the amount of weight gained stratified by race and sex were modest (Table). Black women who gained significant weight were likely to have a worsening of all CVRF, while Hispanic women had the highest likelihood of having an increase in SBP associated with weight gain. In contrast, significant weight gain among men was not associated with worsening CVRF. Conclusions: Significant weight gain was associated with a deleterious impact on CVRF among women but not men. Disparate effects of weight gain between men and women highlight the importance of targeting aggressive weight control interventions toward women to help prevent adverse cardiac outcomes.

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