Increasingly, researchers are recognizing that risk for cardiovascular disease (CVD) in adulthood is rooted in the social and material life conditions of childhood, and that these childhood conditions may predict risk for CVD above and beyond traditional adulthood indicators of socioeconomic status (SES) such as education, occupation or income. Nowhere is this life course perspective on CVD risk more important than in the case of African Americans, especially the generation that """"""""came of age"""""""" in the U.S. South in the late 1950s and 1960s, the peak years of the modern Civil Rights Movement. While some African American members of this age cohort were able to take advantage of the new opportunities for economic advancement, some others were not, resulting thereafter in different life course trajectories of exposure to social and economic hardship. The relationship between variations in these social and economic life course trajectories, and CVD risk (specifically hypertension) in adulthood, has not been investigated in African Americans. The proposed research will address this question in the Pitt County (NC) cohort, a community sample of African Americans (N=1784, 66 percent female, 80 percent response rate) who were between 25-50 years of age at intake in 1988. Normotensives in the baseline sample were re-examined in 1993 (N=1195, 66 percent female, 85 percent response rate). In addition to measuring blood pressure, extensive data on psychosocial, behavioral, and anthropometric characteristics were obtained at both times. The proposed study will re-examine the original cohort in 2001; the anticipated sample size is 1142 individuals (717 women and 425 men). Starting from age 20, respondents' reported exposure to three domains of socioenvironmental stressors will be assessed: (1) adverse socioeconomic conditions; (2) low levels of social integration; and (3) racial discrimination. Taken individually, and then collectively, the greater the cumulative life course exposure to these stressors, the greater the risk for adult hypertension is expected to be. The primary analyses will focus on the relationship between pre-1988 exposures and 1988 BP status (retrospective analyses), and the relationship between pre-1988 exposures and changes in BP status between 1988 and 2001(prospective analyses). The investigators state that the Pitt County study population presents a special opportunity to examine these questions and also contribute to constructing a scientific knowledge base of great relevance to ongoing national efforts to eliminate racial inequalities in CVD.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL065645-03
Application #
6527636
Study Section
Epidemiology and Disease Control Subcommittee 2 (EDC)
Program Officer
Knox, Sara
Project Start
2000-08-15
Project End
2003-07-31
Budget Start
2002-08-01
Budget End
2003-07-31
Support Year
3
Fiscal Year
2002
Total Cost
$370,617
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Type
Schools of Public Health
DUNS #
791277940
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Fowler-Brown, Angela G; Bennett, Gary G; Goodman, Melody S et al. (2009) Psychosocial stress and 13-year BMI change among blacks: the Pitt County Study. Obesity (Silver Spring) 17:2106-9
Roberts, Calpurnyia B; Vines, Anissa I; Kaufman, Jay S et al. (2008) Cross-sectional association between perceived discrimination and hypertension in African-American men and women: the Pitt County Study. Am J Epidemiol 167:624-32
Lucove, Jaime C; Kaufman, Jay S; James, Sherman A (2007) Association between adult and childhood socioeconomic status and prevalence of the metabolic syndrome in African Americans: the Pitt County Study. Am J Public Health 97:234-6
Bennett, Gary G; Wolin, Kathleen Y; James, Sherman A (2007) Lifecourse socioeconomic position and weight change among blacks: The Pitt County study. Obesity (Silver Spring) 15:172-81
James, Sherman A; Van Hoewyk, John; Belli, Robert F et al. (2006) Life-course socioeconomic position and hypertension in African American men: the Pitt County Study. Am J Public Health 96:812-7
James, Sherman A; Fowler-Brown, Angela; Raghunathan, Trevillore E et al. (2006) Life-course socioeconomic position and obesity in African American Women: the Pitt County Study. Am J Public Health 96:554-60