Abstract
PurposeIndependent and combined effects of air pollution and psychosocial stressors on hypertension, a risk factor for cardiovascular disease, among Hispanics are not well studied.MethodsWe administered a pilot-tested questionnaire on individual- and neighborhood-level psychosocial stressors, developed with community input, to nearly 2500 individuals from the MD Anderson Cancer Center cohort of Mexican-Americans. We used data from local air quality monitors to estimate individual exposures to ozone (O3) and fine particulate matter (PM2.5) for the 12-month period preceding enrollment using inverse distance interpolation. We applied logistic regression models to examine relationships between exposures to psychosocial stressors and air pollution with prevalent hypertension and used stratified analyses to examine the interacting effects of these two exposures on hypertension.ResultsThere was a positive association between prevalent hypertension and a high frequency of feeling anxious or depressed (prevalence odds ratio (POR) = 1.36, 95% CI [1.06–1.75]) and experiencing aches and pains (POR = 1.29, 95% CI [1.01–1.64]). The odds of having hypertension were also elevated among those worrying about their own health (POR = 1.65, 95% CI [1.30–2.06]) or about not having enough money (POR = 1.27, 95% CI [1.01–1.6]). We observed an inverse association between O3 and hypertension. There was no interaction between psychosocial stressors and O3 on hypertension.ConclusionOur findings add to the evidence of a positive association between individual and family stressors on hypertension among Hispanics and other racial/ethnic groups. Contrary to previous studies reporting positive associations, our results suggest that long-term exposure to O3 may be inversely related to prevalent hypertension.
Highlights
A relatively large body of literature has examined associations between psychosocial stressors and hypertension, one of the leading risk factors for cardiovascular disease (CVD)
Gallo et al found that self-reported chronic stress was positively associated with increased odds of hypertension (OR = 1.10, 95% confidence intervals (CI) [1.02–1.19]) whereas traumatic stress was associated with a lower odds of hypertension (0R = 0.88, 95%, CI [0.82–0.93]) among adult Hispanics largely from Mexico, Cuba, and Central America [1]
The largest proportion of participants lived in Pasadena (22.11%), a community located east of Houston, near the Houston Ship Channel and numerous industrial facilities
Summary
A relatively large body of literature has examined associations between psychosocial stressors and hypertension, one of the leading risk factors for cardiovascular disease (CVD). Less is known about the impact of psychosocial stress on the risk of hypertension among Hispanics in the United States (U.S.), for whom CVD is the leading cause of death [6]. Gallo et al found that self-reported chronic stress was positively associated with increased odds of hypertension (OR = 1.10, 95% CI [1.02–1.19]) whereas traumatic stress was associated with a lower odds of hypertension (0R = 0.88, 95%, CI [0.82–0.93]) among adult Hispanics largely from Mexico, Cuba, and Central America [1]. Acculturation has been studied as a psychosocial risk factor for hypertension among Hispanics with conflicting findings [8,9,10,11]. LeBron et al report that Latino immigrants are more likely to experience increases in blood pressure associated with individual or institutional discrimination compared to US-born Latinos [14]
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