Abstract MP58: Racial Residential Segregation is Associated With Worse Cardiovascular Health in African American Adults: The Jackson Heart Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Sharrelle Barber ◽  
Kiarri Kershaw ◽  
Xu Wang ◽  
Mario Sims ◽  
Julianne Nelson ◽  
...  
Keyword(s):  
African American ◽  
African Americans ◽  
Residential Segregation ◽  
Cardiovascular Health ◽  
Jackson Heart Study ◽  
Racial Residential Segregation ◽  
African American Adults ◽  
Heart Study ◽  
Neighborhood Environments ◽  
The Impact

Introduction: Racial residential segregation results in increased exposure to adverse neighborhood environments for African Americans; however, the impact of segregation on ideal cardiovascular health (CVH) has not been examined in large, socioeconomically diverse African American samples. Using a novel spatial measure of neighborhood-level racial residential segregation, we examined the association between segregation and ideal CVH in the Jackson Heart Study (JHS). Hypothesis: Racial residential segregation will be associated with worse cardiovascular health among African American adults. Methods: The sample included 4,354 men and women ages 21-93 from the baseline exam of the JHS (2000-2004). Racial residential segregation was assessed at the census-tract level. Data on racial composition (% African American) from the 2000 US Census was used to calculate the local G i * statistic- a spatially-weighted z-score that represents how much a neighborhood’s racial/ethnic composition deviates from the larger metropolitan area. Ideal CVH was assessed using the AHA Life’s Simple Seven (LS7) index which includes 3 behavioral (nutrition, physical activity, and smoking) and 4 biological (systolic BP, glucose, BMI, and cholesterol) metrics of CVH. Multivariable regression models were used to test associations between segregation and the LS7 index continuously (range: 0-14) and categorically (Inadequate: 0-4; Average: 5-9; and Optimal: 10-14). Covariates included age, sex, income, education, and insurance status. Results: The average LS7 summary score was 7.03 (±2.1) and was lowest in the most racially segregated neighborhood environments (High Segregation: 6.88 ±2.1 vs. Low Segregation: 7.55 ±2.1). The prevalence of inadequate CVH was higher in racially segregated neighborhoods (12.3%) compared to neighborhoods that were the least segregated (6.9%). After adjusting for key socio-demographic characteristics, racial residential segregation was inversely associated with ideal CVH (B=-0.041 ±0.02, p=0.0146). Moreover, a 1-SD unit increase in segregation was associated with a 6% increased odds of having inadequate CVH (OR: 1.06, 95% CI: 1.00-1.12, p=0.0461). Conclusion: In conclusion, African Americans in racially segregated neighborhoods are less likely to achieve ideal CVH even after accounting for individual-level factors. Policies aimed at restricting housing segregation/discrimination and/or structural interventions designed to improve neighborhood environments may be viable strategies to improving CVH in this at-risk population.

Association Between Cardiometabolic Factors and Dizziness in African Americans: The Jackson Heart Study

2021 ◽  
Author(s):  
Amrita Ray ◽  
Christopher Spankovich ◽  
Charles E. Bishop ◽  
Dan Su ◽  
Yuan-I Min ◽  
...  
Keyword(s):  
Blood Pressure ◽  
African American ◽  
African Americans ◽  
Noise Exposure ◽  
Medication Use ◽  
Blood Pressure Medication ◽  
Jackson Heart Study ◽  
Screening Questionnaire ◽  
Heart Study ◽  
Cardiometabolic Factors

Abstract Background Balance dysfunction is a complex, disabling health condition that can present with multiple phenotypes and etiologies. Data regarding prevalence, characterization of dizziness, or associated factors is limited, especially in an African American population. Purpose The aim of the study is to characterize balance dysfunction presentation and prevalence in an African American cohort, and balance dysfunction relationship to cardiometabolic factors. Research Design The study design is descriptive, cross sectional analysis. Study Sample The study sample consist of N = 1,314, participants in the Jackson Heart Study (JHS). Data Collection and Analysis JHS participants were presented an initial Hearing health screening questionnaire (N = 1,314). Of these, 317 participants reported dizziness and completed a follow-up Dizziness History Questionnaire. Descriptive analysis was used to compare differences in the cohorts' social-demographic characteristics and cardiometabolic variables to the 997 participants who did not report dizziness on the initial screening questionnaire. Based on questionnaire responses, participants were grouped into dizziness profiles (orthostatic, migraine, and vestibular) to further examine differences in cardiometabolic markers as related to different profiles of dizziness. Logistical regression models were adjusted for age, sex, education, reported noise exposure, and hearing sensitivity. Results Participants that reported any dizziness were slightly older and predominantly women. Other significant complaints in the dizzy versus nondizzy cohort included hearing loss, tinnitus, and a history of noise exposure (p < 0.001). Participants that reported any dizziness had significantly higher prevalence of hypertension, blood pressure medication use, and higher body mass index (BMI). Individuals with symptoms alluding to an orthostatic or migraine etiology had significant differences in prevalence of hypertension, blood pressure medication use, and BMI (p < 0.001). Alternatively, cardiometabolic variables were not significantly related to the report of dizziness symptoms consistent with vestibular profiles. Conclusion Dizziness among African Americans is comparable to the general population with regards to age and sex distribution, accordingly to previously published estimates. Participants with dizziness symptoms appear to have significant differences in BMI and blood pressure regulation, especially with associated orthostatic or migraine type profiles; this relationship does not appear to be conserved in participants who present with vestibular etiology symptoms.

Abstract P348: Association Between Sleep Apnea and Blood Pressure Control Among African-Americans, the Jackson Heart Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Dayna A Johnson ◽  
Stephen J Thomas ◽  
Marwah Abdalla ◽  
Yuichiro Yano ◽  
Na Guo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sleep Apnea ◽  
African Americans ◽  
Resistant Hypertension ◽  
Significant Risk ◽  
Apnea Hypopnea Index ◽  
Jackson Heart Study ◽  
Antihypertensive Medications ◽  
Heart Study ◽  
The Impact

Background: African-Americans have the highest prevalence of elevated blood pressure (BP) and poorer BP control than other racial/ethnic groups in the US. Untreated sleep apnea, common among minority populations, may explain the high prevalence of uncontrolled BP. We studied the association of objective measurements of sleep apnea severity with resistant hypertension and uncontrolled BP among African-Americans in the Jackson Heart Study (JHS) Sleep Ancillary study. Methods: Between 2012 and 2016, JHS participants (N=913) underwent an in-home sleep apnea study (measuring nasal pressure, abdominal and thoracic inductance plethysmography, oximetry, position, ECG); resting blood pressure; anthropometry; and completed questionnaires. Sleep apnea was defined as an apnea-hypopnea index > 15 and nocturnal hypoxemia was quantified as % sleep time <90% oxyhemoglobin saturation (%Sat<90%). Elevated BP was defined as systolic BP ≥ 140 mmHg or diastolic BP > 90mmHg. Controlled BP was defined as systolic BP <140mmHg or diastolic BP <90mmHg. Uncontrolled BP was defined as having elevated BP with use of < 2 antihypertensive medications. Resistant hypertension was defined as having elevated BP while on 3-4 antihypertensive medications with one being a diuretic; or use of > 4 antihypertensive medications. The study sample was limited to individuals with prevalent hypertension (N=613). Multinomial models were fit to determine the association between sleep apnea severity and resistant hypertension or uncontrolled BP (vs. controlled BP) adjusted for age, sex, education, smoking status, obesity (body mass index>30) and diabetes. Results: The study sample had a mean age of 54.8 years, were predominately female (69.8%), obese (57.8%), and college educated (52.7%). Approximately 40.5% had sleep apnea, which was untreated in 95% of individuals. Among the sample, 25.4% had uncontrolled BP and 4.9% were classified as resistant hypertension. After adjustment for confounders, individuals with sleep apnea had a 2.6-fold higher odds of resistant hypertension (95% confidence interval: 1.1, 5.9). A standard deviation higher %Sat<90% was associated with a 41% higher odds (1.1, 1.8) of resistant hypertension after adjustment for covariates. Sleep apnea and %Sat<90% were not related to uncontrolled BP. Conclusion: Among our sample of African-Americans in the JHS, sleep apnea was related to resistant hypertension but not uncontrolled BP. The study identifies the high burden of untreated sleep apnea in African-Americans and its association with resistant hypertension, a significant risk factor for stroke and heart disease. Research is needed on the impact of treating sleep apnea as a strategy for decreasing resistant hypertension, and thus, narrowing cardiovascular health disparities.

scholarly journals Validity and Calibration of Food Frequency Questionnaires Used with African-American Adults in the Jackson Heart Study

2009 ◽  
Vol 109 (7) ◽  
pp. 1184-1193.e2 ◽  
Author(s):  
Teresa C. Carithers ◽  
Sameera A. Talegawkar ◽  
Marjuyua L. Rowser ◽  
Olivia R. Henry ◽  
Patricia M. Dubbert ◽  
...  
Keyword(s):  
African American ◽  
Jackson Heart Study ◽  
Food Frequency ◽  
African American Adults ◽  
Heart Study

scholarly journals Ideal cardiovascular health and peripheral artery disease in African Americans: Results from the Jackson Heart Study

2017 ◽  
Vol 7 ◽  
pp. 20-25 ◽  
Author(s):  
Tracie C. Collins ◽  
David P. Slovut ◽  
Robert Newton ◽  
William D. Johnson ◽  
Sandra Larrivee ◽  
...  
Keyword(s):  
African Americans ◽  
Peripheral Artery Disease ◽  
Cardiovascular Health ◽  
Jackson Heart Study ◽  
Peripheral Artery ◽  
Ideal Cardiovascular Health ◽  
Heart Study ◽  
Artery Disease

scholarly journals The Associations of Multiple Dimensions of Discrimination and Abdominal Fat in African American Adults: The Jackson Heart Study

2012 ◽  
Vol 43 (1) ◽  
pp. 4-14 ◽  
Author(s):  
DeMarc A. Hickson ◽  
Tené T. Lewis ◽  
Jiankang Liu ◽  
David L. Mount ◽  
Sinead N. Younge ◽  
...  
Keyword(s):  
African American ◽  
Abdominal Fat ◽  
Jackson Heart Study ◽  
African American Adults ◽  
Multiple Dimensions ◽  
Heart Study

scholarly journals Housing Insecurity and the Emotional and Physical Health of African Americans

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 335-336
Author(s):  
Aarti Bhat ◽  
August Jenkins ◽  
David Almeida
Keyword(s):  
African American ◽  
African Americans ◽  
Negative Affect ◽  
Physical Health ◽  
The United States ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
African American Adults ◽  
The Impact

Abstract Housing insecurity—or limited and/or unreliable access to quality housing— is a potent on-going stressor that can adversely impact individual well-being. This study extends previous research by investigating the impact of housing insecurity on both the emotional and physical health of aging African American adults using the Midlife in the United States (MIDUS) Refresher oversample of African Americans collected from 2012-2013 (N = 508; M age = 43.02; 57% women). Participants reported on their negative affect, number of chronic health conditions experienced in the last year, and experiences of housing insecurity since the 2008 recession (e.g., homelessness, threatened with foreclosure or eviction, lost home). Negative affect and chronic conditions, respectively, were regressed on housing insecurity, and the potential moderating effect of age was tested. Results showed that housing insecurity was associated with more negative affect (B = 0.05, SE = 0.03, p = .002) and chronic health conditions (B = 0.26, SE = 0.03, p &lt; .001). Additionally, the association between housing insecurity and negative affect was moderated by age (B = -0.11, SE = 0.00, p = .019), such that the effect of housing insecurity on negative affect was stronger for younger adults than for older adults. These results suggest that experiences of insecure housing leave African American adults vulnerable to compromised emotional and physical health, however, the negative effects of housing insecurity may attenuate with age.

Abstract P114: Low Prevalence of Ideal Cardiovascular Health Metrics among African Americans: The Jackson Heart Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Luc Djousse ◽  
Andrew Petrone ◽  
Chad Blackshear ◽  
Michael Griswold ◽  
Jane Harman ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
African Americans ◽  
Cardiovascular Health ◽  
Smoking Status ◽  
Jackson Heart Study ◽  
Men And Women ◽  
Ideal Cardiovascular Health ◽  
Heart Study

Background: While the prevalence of cardiovascular health metrics or Life’s Simple Seven (LSS) has been shown to be far from optimal in the US, such information has been predominantly reported in Caucasians. The burden of cardiovascular disease among African Americans underscores the need to evaluate the prevalence and secular trends of LSS in other ethnic groups. Objective: To test the hypothesis that the prevalence of the LSS is far from ideal among participants of the Jackson Heart Study. Methods: We analyzed LSS with 3,500 African Americans from the Jackson Heart Study, using data from their first clinic visit (2000-2004). Standard methods were used to measure blood pressure, glucose, body mass index (BMI), and cholesterol. Information on physical activity, smoking, and diet was collected with interviewer-administered questionnaires. Each of the LSS metrics (smoking status, diet, physical activity, BMI, fasting blood glucose, total cholesterol, and blood pressure) was categorized as poor, intermediate, or ideal, as defined by the AHA guidelines. Results: The mean age at baseline was 56.9 ± 12.2 years and 2,350 participants (67%) were women. Among men, the prevalence of having 0, 1, 2, 3, 4, 5, 6, and 7 ideal cardiovascular health metrics was 6.6%, 25.8%, 32.7%, 21.6%, 10.6%, 2.3%, 0.4%, and 0%, respectively. Corresponding values for women were 3.2%, 28.1%, 32.9%, 22.3%, 10.1%, 2.9%, 0.38%, and 0%. While about two-thirds of men and women reported ideal smoking status, almost none reported ideal diet quality, and few met recommendations for BMI and blood pressure ( Figure) . Conclusions: Our data are consistent with less than optimal prevalence of cardiovascular health metrics in both men and women from the Jackson Heart Study. The lower prevalence of meeting ideal recommendations for diet, physical activity, BMI, and blood pressure underscores the need for targeted interventions to improve these modifiable lifestyle factors in order to reduce the burden of cardiovascular disease among African-Americans.

Abstract P408: Cardiovascular Health And Recovery From Mobility Limitation in Middle Aged African Americans: The Jackson Heart Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Michelle C Odden ◽  
Kendra D Sims ◽  
Roland Thorpe ◽  
Nancy Min ◽  
Mandip S Dhamoon ◽  
...  
Keyword(s):  
African Americans ◽  
Cardiovascular Health ◽  
Mobility Limitation ◽  
Jackson Heart Study ◽  
Mobility Limitations ◽  
Middle Aged ◽  
Factors Associated ◽  
Phone Calls ◽  
Heart Study ◽  
One Year

Despite a well-established literature demonstrating that African Americans shoulder a high burden of mobility limitation, little is known about factors associated with recovery. Although poor cardiovascular health is a risk factor for mobility limitation, its role in recovery is less clear. The present study investigated demographic and cardiovascular factors associated with recovery from incident mobility limitation within one year in the Jackson Heart Study, a cohort study of African Americans in Jackson, MS. Participants underwent three in-person interviews and exams from 2000-2013, and mobility limitations were assessed by self-reported limitations in walking half a mile or climbing stairs during annual phone calls. The outcome of interest, recovery from mobility limitation, was defined as no mobility limitation the following year. Candidate predictor variables were assessed in logistic regression models and included sociodemographic factors, behaviors, cardiovascular health measures, and chronic conditions. Multiple imputation using chained equations was used to address missing data. Among 5,276 participants [mean (SD) age = 55.4 (12.9) years], 1,759 (33%) had an incident mobility limitation over 12 years of follow-up, and 953 (54%) reported recovery from mobility limitation by one year later. Young women were more likely to recover from mobility limitation than young men. However, with increasing age, women were less likely to recovery from mobility limitation compared with men (p-value for age and gender interaction = 0.03). In adjusted models, being married was associated with a greater likelihood of recovering (OR: 1.26; 95% CI: 1.02, 1.55), whereas a history of heart failure and current statin use were associated with a lower likelihood of recovering (OR = 0.57; 95% CI: 0.34, 0.98 and 0.77; 95% CI: 0.61, 0.98, respectively). In conclusion, the majority of incident mobility limitations in this population of middle-aged African Americans was transient. Being married may support recovery from limitations by providing a form of structural social support. Cardiovascular health status appears to be an important factor in recovery.

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