The proposed study is a longitudinal investigation of social, dietary, and anthropometric predictors of changes in blood pressure in a large, economically diverse southern, Black population. Study participants (665 men, 1,119 women) were between 25-50 years of age in 1988, the year of the baseline survey, and resided in Pitt County, NC. This community is part of a region in the southeastern U.S. known to have elevated mortality from coronary heart disease and stroke. Efforts will be made to re-interview the 1,429 respondents (571 men, 912 women) with untreated, mean diastolic blood pressure < 95 mmHg at baseline, and again at follow-up, on changes in blood pressure during the intervening 4-5 years (1988-1992/93) will be examined. The social variables include socioeconomic status (SES), John Henryism, stress, and social support; the dietary variables include alcohol, sodium, potassium, and calcium; and the anthropometric variables include body mass index (BMI) and waist/hip ratio (WHR). With an emphasis on SES, physical activity, dietary habits, and cigarette smoking, the predictors of weight gain, and changes in patterning of body fat will also be examined. Multiple linear regression will be the primary analytic tool used to study these longitudinal relationships. In cross-sectional analyses which control for physical activity and other important variables, the role of insulin resistance in mediating associations between obesity and blood pressure, and stress and blood pressure, will also be examined. Thus this study aims to clarify interrelationships among social, behavioral, and biological determinants of hypertension in Black Americans. Study findings will be used to plan clinical and public health interventions in this and other similarly high risk Black populations.
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