Abstract 17819: Latent Class Analysis of Heart Health in a Marginalized Black Community

Abstract

BACKGROUND Mounting evidence associates Black American’s experiences of chronic stress with younger age hypertension (HTN) onset, higher prevalence rates, and poorer treatment outcomes. Epigenetic research findings attribute these trends to DNA methylation, commonly referred to as stress related premature biological aging. Guided by the current American Heart Association (AHA) Science Statement on heart health, this health equity study aims to examine positive Black identity as a measure of positive psychological health in Black adults. METHODS Our community-engagement survey measured self-reports of: (1) environmental wellbeing, positive self-regard, spirituality, chronic stress, Black identity, anxiety, depression, anger, and five AHA essential cardiovascular health (CVH) factors: (2) physical activity, fruit, vegetables, smoking tobacco, and sleep. Multivariable linear regressions examined psychological health and CVH as predictors of systolic blood pressure. Latent class analysis (LCA), using ordinal indicators, assessed for latent sample profiles as statistical probabilities of similar responses and sample heterogeneity. RESULTS In a community sample (N=201) of Black adults (age M=46.7, SD=15.9), primarily female (N=141, 69.5%), increases in systolic blood pressure (Mean=134, SD=20.9) were associated with more chronic stress and less environment wellbeing; decreases were associated with less expressed anger. The LCA results show a four-class statistical solution with greater heterogeneity in spirituality, anger, anxiety, and depression. Among the four profiles, two theoretical latent classes for high and low systolic blood pressure were distinct. Low systolic blood pressure is associated with higher levels of environmental wellbeing, physical activity, and self-regard, both more and less spirituality, more positive Black identity, moderate anger, anxiety, and depression, and checking your BP. CONCLUSION In addition to emotion regulation, physical activity, and self-care, our findings support CVH promotion strategies in marginalized communities of Black Americans designed to reduce chronic stress, improve environmental wellbeing, and support positive Black identity.