Abstract P187: Socioeconomic Status and Hypertension in Late Life: The Atherosclerosis Risk in Communities (ARIC) Study

Abstract

Introduction: Individual and area-level socioeconomic status (SES) are associated with hypertension incidence and blood pressure changes in midlife. However, examination of the relationship between SES and late-life hypertension incidence are limited. Methods: ARIC Study participants free of hypertension at visit 4 (1996-1998) were followed by annual and semi-annual calls through December 31, 2013 for incidence of hypertension, defined as a self-reported diagnosis or use of antihypertensive medications. Individual and neighborhood SES indicators were assessed at study baseline (using criteria listed in the Table). Among individuals with follow-up and complete data (N=3,374) associations were examined using Cox regression models. Results: Among men and women with a median baseline blood pressure of 118/68 mg Hg, mean age was 61 years (SD ± 5.5), 45% were female, 12% were Black, and 21.7% had an annual household income of <$25,000 ($36,941 in 2016 dollars). The median neighborhood SES summary z-score was lower among Black (-6.29) compared to White participants (1.69). Over median follow-up of 9.44 years, 1,876 incident hypertension cases were observed. In analyses adjusted for covariates, White participants with high, as compared to low and intermediate measures of SES had lower incidence of hypertension in late life (Table). Results were less consistent among Blacks, possibly due to the smaller sample size and therefore more limited power. After accounting for individual-level SES, there was no association between neighborhood-level SES and incident hypertension. Conclusion: Both neighborhood and individual SES are related to late life incidence of hypertension, at least among Whites. Understanding the mechanisms, such as the role of access to care, for these associations can guide prevention strategies.