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Black–White Blood Pressure Disparities: Depressive Symptoms and Differential Vulnerability to Blood Lead

Background: Blacks have higher hypertension rates than whites, but the reasons for these disparities are unknown. Differential vulnerability, through which stress alters vulnerability to the effects of environmental hazards, is an emergent notion in environmental health that may contribute to these...

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Autores principales: Hicken, Margaret T., Gee, Gilbert C., Connell, Cathleen, Snow, Rachel C., Morenoff, Jeffrey, Hu, Howard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: National Institute of Environmental Health Sciences 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3569674/
https://www.ncbi.nlm.nih.gov/pubmed/23127977
http://dx.doi.org/10.1289/ehp.1104517
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author Hicken, Margaret T.
Gee, Gilbert C.
Connell, Cathleen
Snow, Rachel C.
Morenoff, Jeffrey
Hu, Howard
author_facet Hicken, Margaret T.
Gee, Gilbert C.
Connell, Cathleen
Snow, Rachel C.
Morenoff, Jeffrey
Hu, Howard
author_sort Hicken, Margaret T.
collection PubMed
description Background: Blacks have higher hypertension rates than whites, but the reasons for these disparities are unknown. Differential vulnerability, through which stress alters vulnerability to the effects of environmental hazards, is an emergent notion in environmental health that may contribute to these disparities. Objectives: We examined whether blacks and whites exhibit different associations between blood lead (BPb) and blood pressure (BP) and whether depressive symptoms may play a role. Methods: Using the National Health and Nutrition Examination Survey 2005–2008, we regressed BP on the three-way interaction among race/ethnicity, BPb, and depressive symptoms in blacks and whites ≥ 20 years of age. Results: Blacks but not whites showed a positive association between BPb and systolic blood pressure (SBP). The disparity in this association between blacks and whites appeared to be specific to the high depressive symptoms group. In the low depressive symptoms group, there was no significant black–white disparity (β(interaction) = 0.9 mmHg; 95% CI: –0.9, 2.7). However, of those with high depressive symptoms, blacks and whites had 5.6 mmHg (95% CI: 2.0, 9.2) and 1.2 mmHg (95% CI: –0.5, 2.9) increases in SBP, respectively, in association with each doubling of BPb (β(interaction) = 4.4 mmHg; 95% CI: 0.5, 8.3). The pattern of results was similar for diastolic blood pressure. Conclusions: Our results suggest that depressive symptoms may contribute to the black–white disparity in the association between BPb and BP. Depressive symptoms may result, in part, from psychosocial stress. Our results support the notion that stress increases vulnerability to the health effects of environmental hazards and suggest that stress-related vulnerability may be an important determinant of racial/ethnic health disparities.
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spelling pubmed-35696742013-02-14 Black–White Blood Pressure Disparities: Depressive Symptoms and Differential Vulnerability to Blood Lead Hicken, Margaret T. Gee, Gilbert C. Connell, Cathleen Snow, Rachel C. Morenoff, Jeffrey Hu, Howard Environ Health Perspect Research Background: Blacks have higher hypertension rates than whites, but the reasons for these disparities are unknown. Differential vulnerability, through which stress alters vulnerability to the effects of environmental hazards, is an emergent notion in environmental health that may contribute to these disparities. Objectives: We examined whether blacks and whites exhibit different associations between blood lead (BPb) and blood pressure (BP) and whether depressive symptoms may play a role. Methods: Using the National Health and Nutrition Examination Survey 2005–2008, we regressed BP on the three-way interaction among race/ethnicity, BPb, and depressive symptoms in blacks and whites ≥ 20 years of age. Results: Blacks but not whites showed a positive association between BPb and systolic blood pressure (SBP). The disparity in this association between blacks and whites appeared to be specific to the high depressive symptoms group. In the low depressive symptoms group, there was no significant black–white disparity (β(interaction) = 0.9 mmHg; 95% CI: –0.9, 2.7). However, of those with high depressive symptoms, blacks and whites had 5.6 mmHg (95% CI: 2.0, 9.2) and 1.2 mmHg (95% CI: –0.5, 2.9) increases in SBP, respectively, in association with each doubling of BPb (β(interaction) = 4.4 mmHg; 95% CI: 0.5, 8.3). The pattern of results was similar for diastolic blood pressure. Conclusions: Our results suggest that depressive symptoms may contribute to the black–white disparity in the association between BPb and BP. Depressive symptoms may result, in part, from psychosocial stress. Our results support the notion that stress increases vulnerability to the health effects of environmental hazards and suggest that stress-related vulnerability may be an important determinant of racial/ethnic health disparities. National Institute of Environmental Health Sciences 2012-10-25 2013-02 /pmc/articles/PMC3569674/ /pubmed/23127977 http://dx.doi.org/10.1289/ehp.1104517 Text en http://creativecommons.org/publicdomain/mark/1.0/ Publication of EHP lies in the public domain and is therefore without copyright. All text from EHP may be reprinted freely. Use of materials published in EHP should be acknowledged (for example, ?Reproduced with permission from Environmental Health Perspectives?); pertinent reference information should be provided for the article from which the material was reproduced. Articles from EHP, especially the News section, may contain photographs or illustrations copyrighted by other commercial organizations or individuals that may not be used without obtaining prior approval from the holder of the copyright.
spellingShingle Research
Hicken, Margaret T.
Gee, Gilbert C.
Connell, Cathleen
Snow, Rachel C.
Morenoff, Jeffrey
Hu, Howard
Black–White Blood Pressure Disparities: Depressive Symptoms and Differential Vulnerability to Blood Lead
title Black–White Blood Pressure Disparities: Depressive Symptoms and Differential Vulnerability to Blood Lead
title_full Black–White Blood Pressure Disparities: Depressive Symptoms and Differential Vulnerability to Blood Lead
title_fullStr Black–White Blood Pressure Disparities: Depressive Symptoms and Differential Vulnerability to Blood Lead
title_full_unstemmed Black–White Blood Pressure Disparities: Depressive Symptoms and Differential Vulnerability to Blood Lead
title_short Black–White Blood Pressure Disparities: Depressive Symptoms and Differential Vulnerability to Blood Lead
title_sort black–white blood pressure disparities: depressive symptoms and differential vulnerability to blood lead
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3569674/
https://www.ncbi.nlm.nih.gov/pubmed/23127977
http://dx.doi.org/10.1289/ehp.1104517
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