Clinical InvestigationAssociation between neighborhood-level socioeconomic deprivation and incident hypertension: A longitudinal analysis of data from the Dallas heart study
Section snippets
Dallas heart study (DHS)
The DHS is composed of a multi-ethnic cohort of Dallas County residents ages 18–65 years at baseline and is designed to study cardiovascular disease risk and outcomes. Probability sampling was used to establish the cohort, and African Americans were intentionally oversampled to comprise 50% of the study cohort. This was done to ensure a sufficient cohort of African Americans for analyses by race/ethnicity. Baseline data collection took place from 2000–2002. Detailed data collection methods have
Results
Neighborhood characteristics for the census tracts included in analysis are shown in Table I. Significant differences were observed across tertiles of NDI in all variables.
The study population (n = 1989) consisted of 50% non-Hispanic blacks, 30% non-Hispanic whites, and 20% Hispanic whites. Median follow-up time between the study visits was 7 years. Table II shows population characteristics at baseline, representing a cross-sectional snapshot of the cohort. The NDI distribution ranged from
Discussion
This study adds to the discussion of combatting cardiovascular disease by focusing on the effects of exposure to a deprived neighborhood environment. First, it corroborates existing cross-sectional evidence by demonstrating higher blood pressure and HTN prevalence at baseline within areas of high deprivation. Second, to our knowledge, it is the first to show a longitudinal relationship between neighborhood deprivation and incident HTN while controlling for movement between neighborhoods and
Conclusions
Our study adds to the small but nascent literature on the effects of neighborhood deprivation on HTN incidence, especially in the U.S. The findings suggest that public policy targeting neighborhood-level factors, such as the neighborhood physical environment and available community resources, within Dallas County may be beneficial in improving the cardiovascular health of residents. While improvements to sidewalks, food resources, and recreational areas may substantially improve cardiovascular
Conflicts of interest
none.
Author contributions
Sophie E. Claudel participated in the data analysis and writing the manuscript. Joel Adu-Brimpong participated in the study design, data analysis and drafted the manuscript. Alnesha Banks participated in drafting and reviewing the manuscript. Colby Ayers performed all statistical analyses and contributed to the drafting of the manuscript. Michelle A. Albert, Sandeep Das, James A. de Lemos, Tammy Leonard, Ian J. Neeland and Joshua P. Rivers participated in study design and reviewed analyzed data
Funding
The Powell-Wiley research group is funded by the Division of Intramural Research of the National Heart, Lung, and Blood Institute and the Intramural Research Program of the National Institute of Minority Health and Health Disparities at the National Institutes of Health. This research is also supported by the National Institutes of Health Undergraduate Scholarship Program via funding for Joel Adu-Brimpong and the U.S. Health Resources and Services Administration (HRSA), D34HP16299 (Dr.
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2023, Environmental ResearchCitation Excerpt :These discrepancies may be related to differences in study design (e.g. cross-sectional vs. cohort), case definition (e.g. self-report of hypertension vs. blood pressure measurements), study population, noise exposure estimation protocols, and opportunities for residual confounding (Huang et al., 2015; van Kempen et al., 2018). There are also indications of sociodemographic disparities in noise exposure around U.S. airports (Simon et al., 2022) and in hypertension prevalence and incidence (Aggarwal et al., 2021; Claudel et al., 2018; Lackland, 2014) that warrant consideration in epidemiological studies. Accordingly, we utilized modeled aircraft noise data from 90 U.S. airports to assess the longitudinal association between exposure to aircraft noise and incident hypertension in the Women's Health Initiative (WHI) Clinical Trials.
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