A multi-racial sample of urban adolescents and young adults of both genders who previously participated in three NIH-funded studies while in high school are being recruited for longitudinal follow-up. All subjects were determined to be at risk for the development of essential hypertension as adults when they were originally enrolled in the Project Heart studies in 9th grade. These subjects (n = 131 ) now range in age from 16 - 26 years: 131 remain in high school and 527 have made the transition from high school to work or to work and further education. The impact of the work environment is being examined in the context of other social relations, including family, peer group, neighborhood and school, all of which are embedded in the local community and broader society. An overall objective of this study is to evaluate the contributions of the combined and separate effects of occupational and social environments on adolescents as they mature and develop into adulthood. A primary focus is on the impact of job strain and the characteristics of work on cardiovascular (CV) risk, including measures of blood pressure (BP), both resting and ambulatory, serum cholesterol, and body composition. Jobs characterized by high strain (low job control/high job demand/low social support) are expected to be associated with higher resting and 24-hour ambulatory BP. A second set of analyses will test the hypothesis that emotional vulnerability (anger/high conflict/low social competence) demonstrated in high school predicts both perception of job strain and CV risk. Potential moderating effects of social support from family, friends, co-workers and supervisors and neighborhood environment (neighborhood disadvantage, SES) on CV risk will be examined. During this past year, we have successfully accomplished a workable mechanism to accommodate the movement of study subjects through the Johns Hopkins Medical Institution for completion of the study. We have found that recruitment of high school subjects presents a greater challenge, since the percentage of the current high school cohort who are working is low. Recruitment of these subjects into the study will be delayed until the summer of 2000 when the majority will be employed following high school graduation.
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