Psychosocial Factors and Behaviors in African Americans: The Jackson Heart Study

2017 ◽  
Vol 52 (1) ◽  
pp. S48-S55 ◽  
Author(s):  
Mario Sims ◽  
Kristie J. Lipford ◽  
Nikhil Patel ◽  
Cassandra D. Ford ◽  
Yuan-I Min ◽  
...  
Keyword(s):  
African Americans ◽  
Psychosocial Factors ◽  
Jackson Heart Study ◽  
Heart Study ◽  
And Behaviors

Abstract P307: Association of Psychosocial Factors With Leukocyte Telomere Length Among African Americans in the Jackson Heart Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Christina D Jordan
Keyword(s):  
Depressive Symptoms ◽  
African Americans ◽  
Negative Affect ◽  
Telomere Length ◽  
Psychosocial Factors ◽  
Psychosocial Stressors ◽  
Leukocyte Telomere Length ◽  
Jackson Heart Study ◽  
Heart Study ◽  
Unit Increase

Introduction: Leukocyte telomere length (LTL), a biomarker of cellular aging, is associated with human longevity. Psychosocial stressors are associated with shorter LTL. African Americans (AAs) experience greater stressor levels compared to other racial and ethnic groups. Research on associations of psychosocial factors with LTL among AAs is not well understood. Using Jackson Heart Study (JHS) data, we examined associations of psychosocial factors (negative affect and stressors) with LTL among AAs. Hypothesis: We hypothesized that psychosocial factors are inversely associated with LTL. Methods: Analysis was restricted to 2,516 JHS participants with LTL and psychosocial data between 2000-2004. Cross-sectional associations of negative affect [cynical distrust, anger-in, anger-out, depressive symptoms] and stressors [perceived stress, weekly stress inventory event (WSI-event), WSI-impact, major life event (MLE)] were examined with LTL among participants aged 21-95 years old (women=1,542; men=974). Psychosocial variables were measured by standardized questionnaires; LTL was measured by Southern blot. Summations of the four psychosocial measures were created for negative affect and stressors, with scores ranging from 4-12. We expressed each individual psychosocial measure into categories (tertiles: low, moderate, high) and in continuous standard deviation (SD) units. Using multivariable linear regression we evaluated the associations of psychosocial factors with mean differences (beta coefficient, b) in LTL adjusting for demographics (Model 1), socioeconomic status (SES) (Model 2), health behaviors, cardiovascular disease (CVD) risk factors (Model 3), and coping (Model 4). Results: High (vs low) anger-out was inversely associated with LTL in Model 1 (b = -0.043, p=0.008) and Model 2 (b = -0.0395, p=0.03), where 1-SD unit increase in anger-out was associated with shorter LTL. High (vs low) cumulative negative affect was marginally associated with insignificantly shorter LTL in Model 1 (b = -0.09, p=0.06) and Model 2 (b = -0.09, p=0.07) before transformation to SD units. There was no association between psychosocial stressors and shorter LTL in this sample. Paradoxically, high (vs low) WSI-event was positively associated with LTL (b =0.042, p=0.016), where 1-SD unit increase in WSI-event was associated with longer LTL after full adjustment. Conclusion: Depressive symptoms were associated with LTL shortening in the literature. The current study associates anger-out with shorter LTL, while WSI-event was associated with longer LTL among AAs in the JHS. Possibly, stress pathways that effect telomere length vary, where high stress can trigger LTL lengthening or shortening. Mechanisms of the paradoxical association between stress and telomere length must be further explored among AAs.

Abstract P285: Psychosocial Factors are Associated with Blood Pressure Progression among African Americans in the Jackson Heart Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Cassandra D Ford ◽  
Mario Sims ◽  
John C Higginbotham ◽  
Martha R Crowther ◽  
Sharon B Wyatt ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
African Americans ◽  
Negative Affect ◽  
Psychosocial Factors ◽  
Perceived Stress ◽  
Jackson Heart Study ◽  
Incident Hypertension ◽  
Hypertension Risk ◽  
Heart Study ◽  
Adjusted Model

Background: African Americans (AA) have a higher risk of hypertension than other race/ethnic groups. Research that examines the associations of psychosocial factors with longitudinal changes in blood pressure (BP) and incident hypertension among AA is limited. Using Jackson Heart Study (JHS) data, we hypothesized that negative affect and stress are positively associated with BP progression and incident hypertension among AA. Methods: The JHS is an observational, community-based study of cardiovascular disease (CVD) in AA. Our sample consisted of 1,668 normotensive participants at baseline (2000-2004) (mean age 47±12; 61% women). We investigated sex-pooled 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 negative life events) with BP progression (an increase by one BP stage as defined by JNC VII), incident hypertension and longitudinal changes in systolic and diastolic BP by examination 2 (2005-2008). Poisson regression analysis was utilized to examine the prevalence ratios (PR 95% CI) of BP tracking with psychosocial factors, adjusting for baseline age, sex, socioeconomic status (SES) and hypertension risk factors. Results: Men had higher cynical distrust scores than women (p<.0001). Women had higher anger out, depressive symptoms and perceived stress scores than men (p<.05). Fifty six percent of the sample (934 cases) had BP progression from 2000 to 2008. After adjustment for age and sex, a high anger-out score was associated with a 20% increased prevalence of BP progression compared to a low anger-out score (PR 1.20, 95%CI 1.05,1.36). This association attenuated after adjustment for hypertension risk factors and became non-significant. 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), but not in the fully-adjusted models. High WSI-event scores were associated with BP progression in the fully-adjusted model (PR, 1.21 95% CI 1.04,1.40). Psychosocial factors were not associated with incident hypertension. Conclusions: Psychosocial factors were associated with BP progression, with the strongest evidence for number of stressful events that occurred. Further research is needed to better understand the pathway between exposure to negative affect and stress and BP progression among AA. Keywords: psychosocial, hypertension, health disparities, African Americans, Jackson Heart Study Category: Hypertension

Association of psychosocial factors with leukocyte telomere length among African Americans in the Jackson Heart Study

2018 ◽  
Vol 35 (2) ◽  
pp. 138-145 ◽  
Author(s):  
Christina D. Jordan ◽  
LáShauntá M. Glover ◽  
Yan Gao ◽  
Solomon K. Musani ◽  
Stanford Mwasongwe ◽  
...  
Keyword(s):  
African Americans ◽  
Telomere Length ◽  
Psychosocial Factors ◽  
Leukocyte Telomere Length ◽  
Jackson Heart Study ◽  
Heart Study

scholarly journals Psychosocial Factors Are Associated With Blood Pressure Progression Among African Americans in the Jackson Heart Study

2016 ◽  
Vol 29 (8) ◽  
pp. 913-924 ◽  
Author(s):  
Cassandra D. Ford ◽  
Mario Sims ◽  
John C. Higginbotham ◽  
Martha R. Crowther ◽  
Sharon B. Wyatt ◽  
...  
Keyword(s):  
Blood Pressure ◽  
African Americans ◽  
Psychosocial Factors ◽  
Jackson Heart Study ◽  
Heart Study

Abstract P320: Optimism and Cardiovascular Health Among African Americans in the Jackson Heart Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Mario Sims ◽  
LáShauntá Glover ◽  
Arnita Norwood ◽  
Christina Jordan ◽  
Yuan-I Min ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
African Americans ◽  
Psychosocial Factors ◽  
Sex Education ◽  
Cardiovascular Health ◽  
Multinomial Logistic Regression ◽  
Jackson Heart Study ◽  
Heart Study ◽  
Increased Risk

Introduction: Compared to other racial and ethnic groups, African Americans experience greater negative psychosocial factors (depression, stress), which are related to increased risk of cardiovascular disease (CVD). Little research has examined the association of positive psychosocial factors (optimism) with cardiovascular health in this population. Using the Jackson Heart Study (JHS) data, we examined the association of optimism with the American Heart Association Life’s Simple 7 TM (LS7), a measure of seven metrics that assesses a person’s cardiovascular health. Hypothesis: Higher levels of optimism are positively associated with individual LS7 metrics, and positively associated with the total LS7 score. Methods: We evaluated cross-sectional associations of optimism with each LS7 metric [cigarette smoking, physical activity, diet, body mass index (BMI), blood pressure, cholesterol, glucose] and with a composite LS7 score among 4,761 participants, 21-95 years old (women=3,070; men=1,691) enrolled in the JHS, a single-site, community-based cohort of African Americans residing in Jackson, MS. Optimism was measured in tertiles (low, moderate, high) to examine threshold effects. Each LS7 metric was classified as poor, intermediate, and ideal. LS7 metrics were also summed to create a total continuous score (0-13) categorized in tertiles (low, moderate, high). Multinomial logistic regression estimated the odds ratios (OR, 95% confidence interval-CI) of intermediate (vs. poor) and ideal (vs. poor) LS7 metric by levels of optimism. Multinomial regression also estimated the odds of moderate (vs. low) or high (vs. low) total LS7 score by optimism. Models adjusted for demographics, SES, and depressive symptoms. Results: Descriptive findings showed that participants who reported high optimism had ideal physical activity, nutrition, smoking, blood pressure, glucose and high total LS7 score (all p<0.01). After adjustment for age, sex, education, income, marital status, and insurance status, participants who reported high (vs. low) optimism had a 39% increased odds of having ideal (vs. poor) physical activity (OR 1.39; 95% CI 1.10-1.76) and a 33% increased odds of having ideal (vs. poor) smoking (OR 1.33; 95% CI 1.02-1.73). Participants who reported high (vs. low) optimism had a 34% greater odds of having a high (vs. low) total LS7 score (OR 1.34 95% CI 1.03-1.74) after full adjustment. Conclusion: Optimism is associated with ideal physical activity and ideal smoking, which is important for promoting cardiovascular health and reducing the risk of CVD among African Americans in this sample.

scholarly journals Neighborhood social environment as risk factors to health behavior among African Americans: The Jackson Heart Study

2017 ◽  
Vol 45 ◽  
pp. 199-207 ◽  
Author(s):  
Xu Wang ◽  
Amy H. Auchincloss ◽  
Sharrelle Barber ◽  
Stephanie L. Mayne ◽  
Michael E. Griswold ◽  
...  
Keyword(s):  
Risk Factors ◽  
African Americans ◽  
Health Behavior ◽  
Social Environment ◽  
Jackson Heart Study ◽  
Heart Study

Abstract P439: Risk Factor Profile and Prevalence of Subclinical Disease in African Americans with Diabetes and Metabolic Syndrome: The Jackson Heart Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Kamel A Gharaibeh ◽  
Vanessa Xanthakis ◽  
Jung Hye Sung ◽  
Tandaw S Samdarshi ◽  
Herman A Taylor ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Risk Factor ◽  
African Americans ◽  
Left Ventricular ◽  
Jackson Heart Study ◽  
Cvd Risk ◽  
Metabolic Derangement ◽  
Risk Factor Profile ◽  
Subclinical Disease ◽  
Heart Study

Background . Metabolic derangements such as diabetes (DM) and metabolic syndrome (MetS) are common in African Americans (AA) and contribute to the higher cardiovascular disease (CVD) mortality in this group. A greater prevalence of subclinical disease (ScD) among those with DM and MetS in the AA community may be an explanatory factor. Objective . We assessed the CVD risk factor profile and distribution of ScD among AA with DM and MetS in the Jackson Heart Study (JHS). Methods . We evaluated 4,365 AA participants [mean age (SD) of 53.8 (12.3) years, 64.5% women] free of overt CVD who attended JHS Exam 1 (between 2000- 2004), when ScD assessment was routinely performed(with the exception of CT for coronary calcium that occurred in Exam2). SCD measures included 1) peripheral artery disease (PAD, defined as ankle-brachial index<0.9), 2) high coronary artery calcium (CAC, defined as score>100), 3) left ventricular (LV) hypertrophy (LVH defined as left ventricular mass index>51 g/m 2.7 , 4) low LV ejection fraction (low EF, defined as an EF<50%), and 5) microalbuminuria (MA, defined as an albumin-to-creatinine ratio>25 μg/mg in men and >35 μg/mg in women). We compared the distribution of standard CVD risk factors and ScD prevalence in 1) those without DM or MetS (referent), 2) those with MetS but no DM and 3) those with DM. Results . In our study sample, 1,089 (24.9%) had MetS with no DM and 752 (17.2%) had DM. Compared to the referent group, groups with metabolic derangement tended to be older, female, hypertensive, obese, and had lower HDL, higher fasting glucose, and higher triglycerides levels. Table 1 compares the distribution of ScD for the three groups, and demonstrates the greater odds of. CAC, LVH and microalbuminuria in participants with MetS or DM. Conclusion . In our large community-based sample of AAs, we observed a significantly high prevalence of ScD overall, especially so in participants with MetS and DM. These findings likely contribute to the high CVD rates in AA with MetS and DM. -->

Abstract P159: Coronary Artery Calcium Score Improves the Net Reclassification Index of Prevalent Cardiovascular Disease In African Americans: The Jackson Heart Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Joseph Yeboah ◽  
Che L Smith ◽  
Mario Sims ◽  
Ervin Fox ◽  
Yaorong Ge ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
High Risk ◽  
African Americans ◽  
Diagnostic Accuracy ◽  
Coronary Artery Calcium ◽  
Smoking Status ◽  
Jackson Heart Study ◽  
Net Reclassification Improvement ◽  
Heart Study

Background: Prior studies suggest that African Americans (AA) have lower prevalence of coronary artery calcium (CAC) compared to whites, yet CAC has similar ability to predict coronary heart disease (CHD) events. The role of CAC as a screening tool for CHD risk in AA is unclear. We compared the diagnostic accuracy for CHD prevalence using the CAC score and the Framingham Risk Score (FRS) in an adult population of AA. Methods: CAC was measured in 2944 participants in the Jackson Heart Study, an NHLBI funded study of AA based in Jackson, MS. Approximately 8% of this cohort had known cardiovascular disease (CVD) defined as prior MI, angina, stroke, PTCA, CABG or PVD. Logistic regression, ROC and net reclassification index (NRI) analysis were used adjusting for age, gender, SBP, total and HDL cholesterol, smoking status, DM and BMI. FRS was calculated and those with DM were classified as high risk. Results: The mean age was 60, 65% were females, 26% had DM, 50% were obese and 30% were current or former smokers. Prevalent CVD was associated with older age, higher SBP, lower HDL and total cholesterol, and higher CAC. CAC was independently associated with prevalent CVD in our multivariable model [OR (95% CI): 1.26 (1.17, 1.35), p< 0.0001]. In ROC analysis, CAC improved the diagnostic accuracy (c statistic) of the FRS from 0.617 to 0.757 (p < 0.0001) for prevalent CVD. The FRS classified 30% of the cohort as high risk, 38.5% as intermediate risk and 31.5% as low risk. FRS classfied 51% of subjects with prevalent CVD as high risk. Addition of CAC to FRS resulted in net reclassification improvement of 4% for subjects with known CVD and 28.5% in those without CVD (see figure). Conclusion: In AA, the CAC is independently associated with prevalent CVD and improves the diagnostic accuracy of FRS for prevalent CVD by 14%. Addition of CAC improves the NRI of those with prevalent CVD by 4% and the NRI of individuals without CVD by 28.5%. Determination of CAC in AA may be useful in identifying individuals at risk of CVD and reclassifying individuals with low and intermediate FRS.

Abstract P012: Hypertension and Alterations in Left Ventricular Geometry in African Americans: The Jackson Heart Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Marwah Abdalla ◽  
John N Booth ◽  
Keith M Diaz ◽  
Mario Sims ◽  
Paul Muntner ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
African Americans ◽  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Jackson Heart Study ◽  
Antihypertensive Medications ◽  
Geometric Patterns ◽  
Ventricular Geometry ◽  
Disease Outcomes ◽  
Heart Study

Introduction: Compared with whites, African Americans (AAs) have a higher risk for hypertension-related cardiovascular disease outcomes, which may be related to alterations in left ventricular geometry. Scarce data exist on how the left ventricle remodels in response to hypertension among AAs. Hypothesis: We hypothesized that among AAs, hypertension will be associated with abnormal echocardiographic–derived left ventricular geometric patterns defined as concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH). Methods: We analyzed data from the Jackson Heart Study, a community-based AA cohort who completed a baseline exam that included clinic blood pressure (CBP) and 2D echocardiography (n=5,301). CR, CH, EH, and normal patterns were defined according to left ventricular mass index and relative wall thickness defined using standard American Society of Echocardiography recommendations. The analysis was restricted to 4,572 participants with complete CBP, information on antihypertensive medication, and echocardiographic data. Results: Mean ± SD age was 55.5 ± 12.7 years; 64% were female. Mean ± SD systolic and diastolic CBP was 127 ± 18 and 79 ± 11 mmHg, respectively; 2,785 (61%) of participants had hypertension (CBP ≥140/90 mmHg and/or taking antihypertensive medications). The prevalence of CR, CH, and EH were 10.1%, 5.2%, and 8.2%, respectively. In a multivariable-adjusted model with a normal pattern as the referent group, hypertension was associated with a greater risk of CR, CH, and EH: odds ratio 1.85 (95% confidence interval (CI) 1.43-2.38), 4.16 (95% CI 2.53-6.86), and 1.67 (95% CI: 1.26-2.23) respectively. Among hypertensive participants, older age was significantly associated with CR, CH, and EH after multivariable adjustment. Higher systolic CBP, current smoking and a higher number of classes of antihypertensive medications were additionally significantly associated with CH and EH. Male sex, and heavy and moderate alcohol consumption versus none were also significantly associated with CR. Conclusions: In conclusion, abnormal left ventricular geometry was present in almost 25% of AAs. Hypertension was associated with each abnormal geometric pattern, with approximately a four-fold greater odds for CH. Future studies should examine whether abnormal left ventricular geometric patterns, particularly CH, explains the increased risk of cardiovascular disease outcomes associated with hypertension in AAs.

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