Abstract

Hypertension is a major cardiovascular risk factor. Gang violence is an unfortunately common reality in urban communities and violence is associated with worse cardiovascular outcomes. However, the relationship between street gang territories and cardiovascular risk is unknown. We conducted a retrospective cohort study to determine if residence within a street gang territory is associated with higher blood pressure compared with demographically similar patients who resided outside of gang territories within Chicago. A balanced dataset of 1,016 unique-but-demographically-similar patients with at least 3 available pre-pandemic ambulatory blood pressure measurements at our urban, academic tertiary-care center were sampled from over 70,561 available patients. Patients were matched for the number of BP measurements, age, race, sex, and other sociodemographic variables. Patients were geo-coded and mapped, and known street gang territories were similarly geo-coded and mapped using publicly available data from the Chicago Police Department data portal. Out of 66 known street gangs in Chicago, our institution served patients from 28 unique gang territories. Patients residing within a known street gang territory had on average 6.2 mmHg higher BP than those living outside any known street gang territory (median = 133.2 vs 127.0, respectively,p<0.001). SBP control in each unique street gang territory was highly variable with medians ranging between 108.8 to 165.0 mmHg (Figure). In conclusion, we find that residence within a street gang territory is associated with significantly higher systolic blood pressure compared with demographically similar patients who do not live in a gang territory. While poverty and other social determinants of health are known to affect hypertension and cardiovascular risk, residence within a gang territory may represent a new social risk factor for cardiovascular disease.

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