Abstract
Purpose: We examined whether sleep characteristics and adverse social exposures were associated with elevated blood pressure (BP) in young adult black women.Methods: This is a cross-sectional analysis of existing data from 581 black females who participated in the National Longitudinal Study of Adolescent to Adult Health (Add Health). Adverse social exposures included child abuse, discrimination, perceived stress, social isolation, and subjective social status. Self-reported sleep characteristics were measures of duration, latency, continuity, and snoring. Logistic regression was used to evaluate the influence of social exposures and sleep characteristics on BP.Results: Among the women (mean age=29.1 years), 32.4% had elevated BP (≥130 systolic or ≥80 diastolic). In adjusted analysis, poor sleep continuity (adjusted odds ratio [aOR]=1.70, 95% confidence interval [CI]=1.07–2.70) and discrimination (aOR=1.61, 95% CI=1.00–2.58) were associated with higher odds of elevated BP, while more social isolation (aOR=0.69, 95% CI=0.48–0.99) was associated with lower odds of elevated BP.Conclusion: Poor sleep continuity and experiencing discrimination may represent key risk factors for hypertension in young black females. Unexpectedly, being more isolated was associated with lower BP. Future research should examine how to adapt current paradigms and measures of social connectedness, isolation, and stress to better elucidate the impact of these factors on the long-term health of young black females.
Highlights
Hypertension is among the top three leading contributors to death and disability worldwide,[1] and black females are among the most affected
Purpose: We examined whether sleep characteristics and adverse social exposures were associated with elevated blood pressure (BP) in young adult black women
The odds of elevated BP were significantly higher among those who reported the following: (1) snoring or being told that they stopped breathing when asleep (OR = 1.72, 95% confidence intervals (CIs) = 1.21–2.45) and (2) poor sleep continuity (OR = 1.53, 95% CI = 1.03–2.27)
Summary
Hypertension is among the top three leading contributors to death and disability worldwide,[1] and black females are among the most affected. Elevated blood pressure (BP) develops at younger ages in black females compared to women of other ethnicities.[1,3] More attention to risk factors that contribute to elevated BP in black women younger than 40 years is needed. Known risk factors for elevated BP, such as obesity and family history, do not fully explain the disparity in elevated BP prevalence, especially among young black females.[4,5] Mounting evidence suggests that adverse social exposures, including child abuse,[5,6] social isolation,[7,8] discrimination,[9,10,11] and socioeconomic disadvantage,[11,12,13] have a negative impact on physical health. Owing to the social stratification of society, discrimination is a social adversity that many black women experience.[10,11,14] In the Jackson Heart Study, a prospective, cohort study of black
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