Abstract 12276: The Mediating Effects of Insomnia Symptom Severity on the Relationship Between Acculturation Stress and the Prevalence of Hypertension Among Latinx Adults

Abstract

Introduction: Hypertension (HTN), a well-known risk factor for cardiovascular morbidity and mortality, affects about 44% of Latinxs in the US. Acculturation stress, a type of sociocultural stress, is associated with poor cardiovascular outcomes (i.e., HTN), in this population yet the mechanisms driving this association are understudied. Insomnia symptom severity(ISI) has been associated with increased acculturation stress and increased risk of HTN. So, ISI may drive the positive association between acculturation stress and HTN among Latinxs. We aim to examine the direct and indirect effects of acculturation stress on the prevalence of HTN via ISI among Latinxs. Hypothesis: We hypothesize that increased acculturation stress will be directly and indirectly associated with an increased prevalence of hypertension via increasing ISI. Methods: Using a sample of Latinx adults participating in the Hispanic Community Health Survey/Study of Latinos Baseline and Sueño Ancillary studies (n=1464), we conducted weighted unadjusted and adjusted bias corrected bootstrap tests of mediation. Acculturation stress was measured through the Hispanic Stress Index. ISI was measured through the Insomnia Severity Index. Hypertension was categorized as blood pressure &gt130/80 or antihypertensive medication use. Adjustments for age, sex, nativity status, body mass index, and site were made. Results: Participants were M age=41.99 (SD=12.96). Most were women (53.76%), immigrants (65.44%), and of Mexican heritage (31.80%). Participants had a M ISI=7.38 (SD=6.49). About 39.01% were hypertensive. The total and direct effects of acculturation stress on the prevalence of HTN were statistically significant (PR=1.01, 95% CI: 1.00-1.02; PR=1.01, 95%CI: 1.00-1.02). ISI was a statistically significant mediator in the relationship between increased acculturation stress and increased prevalence of HTN in unadjusted models (Indirect effect=0.002, BCa 95% CI: 0.0002-0.004). Conclusions: Results suggest acculturation stress impacts HTN via increasing ISI among Latinxs. These findings should be replicated using longitudinal designs. If replicated, ISI may be an important target of intervention to mitigate the effects of acculturation stress on HTN among Latinxs.