Abstract 10779: Lower Socioeconomic Status, Psychological Distress, and Hypertension: A Longitudinal Moderated Mediation Analysis

Abstract

Introduction: Lower socioeconomic status (SES) has been associated with hypertension (HTN); however, the mediators and moderators of this association remain understudied. We used longitudinal data to examine the mediating effect of psychological distress on the link between lower SES and HTN, as well as the racial and sex moderation effects. Methods: This study was a secondary analysis of data collected from 2009 to 2019 among adults with six-wave biennial surveys from the Panel Study of Income Dynamics (PSID). SES was assessed with individuals’ education, employment status, and income. The Kessler K6 scale was used to assess psychological distress. HTN was a self-reported physician-diagnose. Data of families’ head who did not have HTN in 2009 were analyzed. Sequential mediation and moderated mediation models were performed using the PROCESS macro in SPSS. Results: The mean age of the sample in 2009 was 45 years (33% female). The prevalence of HTN increased significantly from 31% in 2009 to 41% in 2019. Participants who had no HTN with lower SES in 2009 were more likely to develop HTN in 2019 (OR=1.11, 95% CI: 1.03-1.20, p <0.01). Sequential mediation analysis showed that psychological distress was a significant mediator of the association between lower SES and HTN (indirect effect=0.02, p <0.05) and the mediation effect was moderated by sex but not by race. Females with lower SES were at a higher risk (index of moderated mediation=0.01, p <0.05). Conclusions: Lower SES was longitudinally associated with increased risk of HTN 10 years later. The link of lower SES and HTN was mediated by psychological distress and sex moderated the mediation effect. Sex-tailored interventions of psychological distress should be considered to reduce risk of HTN in lower SES individuals.