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Roettger ME, Tan J, Houle B, Najman JM, McGee T. Adolescent behavioral problems, preterm/low birth weight children and adult life success in a prospective Australian birth cohort study. Prev Med 2024; 185:108061. [PMID: 38972605 DOI: 10.1016/j.ypmed.2024.108061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 07/02/2024] [Accepted: 07/04/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND Preterm and/or low birthweight (PT/LBW) is predictive of a range of adverse adult outcomes, including lower employment, educational attainment, and mental wellbeing, and higher welfare receipt. Existing studies, however, on PT/LBW and adult psychosocial risks are often limited by low statistical power. Studies also fail to examine potential child or adolescent pathways leading to later adult adversity. Using a life course framework, we examine how adolescent problem behaviors may moderate the association between PT/LBW and a multidimensional measure of life success at age 30 to potentially address these limitations. METHODS We analyze 2044 respondents from a Brisbane, Australia cohort followed from birth in1981-1984 through age 30. We examine moderation patterns using obstetric birth outcomes for weight and gestation, measures of problem behaviors from the Child Behavioral Checklist at age 14, and measures of educational attainment and life success at 30 using multivariable normal and ordered logistic regression. RESULTS Associations between PT/LBW and life success was found to be moderated by adolescent problem behaviors in six scales, including CBCL internalizing, externalizing, and total problems (all p < 0.01). In comparison, associations between LBW and educational attainment illustrate how a single-dimensional measure may yield null results. CONCLUSION For PT/LBW, adolescent problem behaviors increase risk of lower life success at age 30. Compared to analysis of singular outcomes, the incorporation of multidimensional measures of adult wellbeing, paired with identification of risk and protective factors for adult life success as children develop over the lifespan, may further advance existing research and interventions for PT/LBW children.
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Affiliation(s)
- Michael E Roettger
- School of Demography, The Australian National University, 146 Ellory Crescent, Acton ACT 2601, Australia.
| | - Jolene Tan
- School of Demography, The Australian National University, 146 Ellory Crescent, Acton ACT 2601, Australia
| | - Brian Houle
- School of Demography, The Australian National University, 146 Ellory Crescent, Acton ACT 2601, Australia; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jake M Najman
- School of Public Health, Public Health Building, The University of Queensland, Herston 4006, Australia
| | - Tara McGee
- School of Criminology and Criminal Justice, Griffith University, 176 Messines Ridge Road, Mount Gravatt, QLD 4122, Australia
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Blake AL, Bennett NR, McKenzie JA, Tulloch-Reid MK, Govia I, McFarlane SR, Walters R, Francis DK, Wilks RJ, Williams DR, Younger-Coleman NO, Ferguson TS. Social support and ideal cardiovascular health in urban Jamaica: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003466. [PMID: 39078827 PMCID: PMC11288424 DOI: 10.1371/journal.pgph.0003466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 06/19/2024] [Indexed: 08/02/2024]
Abstract
Recent studies have suggested that high levels of social support can encourage better health behaviours and result in improved cardiovascular health. In this study we evaluated the association between social support and ideal cardiovascular health among urban Jamaicans. We conducted a cross-sectional study among urban residents in Jamaica's south-east health region. Socio-demographic data and information on cigarette smoking, physical activity, dietary practices, blood pressure, body size, cholesterol, and glucose, were collected by trained personnel. The outcome variable, ideal cardiovascular health, was defined as having optimal levels of ≥5 of these characteristics (ICH-5) according to the American Heart Association definitions. Social support exposure variables included number of friends (network size), number of friends willing to provide loans (instrumental support) and number of friends providing advice (informational support). Principal component analysis was used to create a social support score using these three variables. Survey-weighted logistic regression models were used to evaluate the association between ICH-5 and social support score. Analyses included 841 participants (279 males, 562 females) with mean age of 47.6 ± 18.42 years. ICH-5 prevalence was 26.6% (95%CI 22.3, 31.0) with no significant sex difference (male 27.5%, female 25.7%). In sex-specific, multivariable logistic regression models, social support score, was inversely associated with ICH-5 among males (OR 0.67 [95%CI 0.51, 0.89], p = 0.006) but directly associated among females (OR 1.26 [95%CI 1.04, 1.53], p = 0.020) after adjusting for age and community SES. Living in poorer communities was also significantly associated with higher odds of ICH-5 among males, while living communities with high property value was associated with higher odds of ICH among females. In this study, higher level of social support was associated with better cardiovascular health among women, but poorer cardiovascular health among men in urban Jamaica. Further research should explore these associations and identify appropriate interventions to promote cardiovascular health.
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Affiliation(s)
- Alphanso L. Blake
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
- School of Clinical Medicine and Research, The Faculty of Medical Sciences, The University of the West Indies, Nassau, The Bahamas
| | - Nadia R. Bennett
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Joette A. McKenzie
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Marshall K. Tulloch-Reid
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Ishtar Govia
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Shelly R. McFarlane
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Renee Walters
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Damian K. Francis
- School of Health and Human Performance, Georgia College and State University, Milledgeville, Georgia, United States of America
| | - Rainford J. Wilks
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Novie O. Younger-Coleman
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Trevor S. Ferguson
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
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McCaw-Binns A, Asnani M. Reliability of self-reported data from the 2011 Ja-Kids birth cohort study: demographic, social, obstetric history, medical and outcome indicators. PSYCHOL HEALTH MED 2024; 29:1179-1193. [PMID: 34493112 DOI: 10.1080/13548506.2021.1975782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 08/25/2021] [Indexed: 10/20/2022]
Abstract
The Ja-Kids Longitudinal Study (JA-Kids) aims to improve the health and development of Jamaican children by identifying social, demographic, environmental and clinical factors that help or hinder these processes. As clinical indicators relied on maternal reporting, we aim to evaluate the quality of the self-reported data. Women were recruited across Jamaica during pregnancy or at delivery from July 1-30 September 2011. Indicators were compared between women recruited while pregnant and at delivery to understand possible differences between the sub-populations. Variables reported more than once between pregnancy and delivery were assessed to evaluate level of agreement (reliability). Clinical indicators from the literature were contrasted with study findings to determine how maternal reporting align with published prevalence (validity). Intra-class correlation and the kappa (κ) statistic were used to assess reliability while chi-squared, Fisher's-exact or students-t were used to compare differences over time; p values ≤0.05 were considered statistically significant. Women recruited during pregnancy (n = 3970) were younger, less parous and possibly more socially disadvantaged than those recruited at delivery (n = 5803). Socio-demographic and selected clinical indicators showed good to moderate (0.421 < κ < 0.681) reporting consistency between pregnancy and delivery for previous C-section (κ = 0.681), pre-existing diabetes mellitus (κ = 0.616) and prior twin gestations (0.580). Most conditions however showed only fair agreement (0.21 < κ < 0.40) including previous gestational hypertension (κ = 0.387), asthma (κ = 0.365), premature rupture of membranes (κ = 0.324), eclampsia (κ = 0.257) and essential hypertension (κ = 0.213). Infectious conditions had poor reliability. Prevalence rates for most conditions, except sickle cell disease, were lower than the published literature. Complications and outcomes which were well defined for women were better reported than those requiring clinical judgment (e.g. prior C-section versus specific hypertensive disorders of pregnancy). NCDs with only episodic acute effects were not well reported, e.g. asthma, hypertension and sickle cell disease. Maternal reporting of pregnancy complications needs to be interpreted with caution.
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Affiliation(s)
- Affette McCaw-Binns
- Department of Community Health and Psychiatry, Faculty of Medical Sciences, The University of the West Indies, Kingston, Jamaica
| | - Monika Asnani
- Caribbean Institute for Health Research- Sickle Cell Unit, the University of the West Indies, Kingston, Jamaica
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Mallinson PAC, Lieber J, Kinra S. Childhood Socioeconomic Position and Risk of Cardiovascular Disease in Adulthood: Systematic Review of Evidence From Low- and Middle-Income Countries. Am J Prev Med 2021; 61:e251-e266. [PMID: 34272136 DOI: 10.1016/j.amepre.2021.04.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/06/2021] [Accepted: 04/21/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Socioeconomic disadvantage in childhood is strongly associated with a higher risk of cardiovascular disease in high-income countries. However, the association in low- and middle-income countries, where childhood poverty remains prevalent, has not been reviewed. METHODS The authors systematically searched Embase, MEDLINE, and Global Health databases for articles on the association between childhood socioeconomic position and risk of cardiovascular disease in adulthood in low- and middle-income countries until September 2020. Outcomes included measures of cardiovascular disease, its subclinical markers (e.g., carotid intima-media thickness), and its major risk factors (e.g., hypertension, dyslipidemia, diabetes). Where available, associations were extracted before and after adjustment for socioeconomic position in adulthood. Results were synthesized qualitatively by outcome. The study protocol is registered on PROSPERO (CRD42018086984). RESULTS The search returned 3,568 unique abstracts, from which 29 eligible articles from 14 middle-income countries were identified, representing >150,000 participants. The most commonly reported outcomes were cardiovascular risk factors; very few studies reported prevalent measures of cardiovascular disease, and no studies reported cardiovascular disease incidence or mortality. Of the 46 reported associations between childhood socioeconomic position and risk of cardiovascular disease, 8 were inverse, 0 were positive, and 38 showed no clear evidence of association. All articles had high (16/29) or medium (13/29) risk of bias. CONCLUSIONS Current evidence from middle-income countries provides little support for an association between childhood socioeconomic position and risk of cardiovascular disease, and evidence from low-income countries is lacking. It would be premature to consider childhood poverty as a target for cardiovascular disease prevention in these settings.
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Affiliation(s)
- Poppy Alice Carson Mallinson
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Judith Lieber
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom; Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sanjay Kinra
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Huang C, Yu Y, Sørensen HT, Liu B, Vested A, Cnattingius S, Qin G, Li J. Maternal education before childbirth and cardiovascular diseases in offspring during early adulthood: a Danish population-based cohort study. Can J Cardiol 2021; 37:1951-1958. [PMID: 34273473 DOI: 10.1016/j.cjca.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/02/2021] [Accepted: 07/09/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is increasing in youths, but there is limited knowledge about the etiology of early-onset CVD. We aimed to examine the association between maternal education before childbirth and CVD risk in offspring during early adulthood (20-40 years old). METHODS AND RESULTS This population-based cohort study included 1123600 individuals born in Denmark during 1977-1996. Compared to offspring born to mothers with high education, offspring born to mothers with low or medium education had 27% (hazard ratio, 1.27; 95% confidence interval, 1.23-1.30) or 12% (1.12; 1.09-1.15) increased overall risk of early-onset CVD, respectively. Increased risks were observed for most type-specific CVDs, in particular for myocardial infarction low [2.03; 1.55-2.65] or medium education [1.52; 1.16-1.99]), heart failure (low [1.59; 1.24-2.03] or medium education [1.51; 1.19-1.92]), and ischemic stroke (low [1.50; 1.28-1.76] or medium education [1.29; 1.10-1.51]). We observed high incidences of CVD in offspring of mothers with comorbid CVD (low [1.67; 1.51-1.86] or medium education [1.46; 1.29-1.64]), compared with those of mothers with high education and no CVD history. CONCLUSIONS Low maternal education before childbirth, especially with maternal comorbid CVD, is significantly associated with increased risk of overall CVD and most type-specific CVDs in offspring in early adulthood. The influence of maternal education on future offspring CVD should be taken into consideration in the assessment of CVD risks from early decades of life.
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Affiliation(s)
- Chen Huang
- Department of Biostatistics, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Yongfu Yu
- Department of Biostatistics, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Department of Clinical Medicine-Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.
| | - Henrik Toft Sørensen
- Department of Clinical Medicine-Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Buyun Liu
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, USA
| | - Anne Vested
- Department of Clinical Medicine-Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Sven Cnattingius
- Division of Clinical Epidemiology, Department of Medicine, Solna, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
| | - Guoyou Qin
- Department of Biostatistics, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
| | - Jiong Li
- Department of Clinical Medicine-Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.
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Ferguson TS, Younger-Coleman NOM, Mullings J, Francis D, Greene LG, Lyew-Ayee P, Wilks R. Neighbourhood socioeconomic characteristics and blood pressure among Jamaican youth: a pooled analysis of data from observational studies. PeerJ 2020; 8:e10058. [PMID: 33083129 PMCID: PMC7546221 DOI: 10.7717/peerj.10058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 09/07/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction Neighbourhood characteristics are associated with several diseases, but few studies have investigated the association between neighbourhood and health in Jamaica. We evaluated the relationship between neighbourhood socioeconomic status (SES) and blood pressure (BP) among youth, 15-24 years old, in Jamaica. Methods A pooled analysis was conducted using data from three studies (two national surveys and a birth cohort), conducted between 2005-2008, with individual level BP, anthropometric and demographic data, and household SES. Data on neighbourhood SES were obtained from the Mona Geo-Informatics Institute. Neighbourhood was defined using community boundaries from the Social Development Commission in Jamaica. Community characteristics (poverty, unemployment, dependency ratio, population density, house size, and proportion with tertiary education) were combined into SES scores using principal component analysis (PCA). Multivariable analyses were computed using mixed effects multilevel models. Results Analyses included 2,556 participants (1,446 females; 1,110 males; mean age 17.9 years) from 306 communities. PCA yielded two neighbourhood SES variables; the first, PCA-SES1, loaded highly positive for tertiary education and larger house size (higher value = higher SES); while the second, PCA-SES2, loaded highly positive for unemployment and population density (higher value = lower SES). Among males, PCA-SES1 was inversely associated with systolic BP (β-1.48 [95%CI -2.11, -0.84] mmHg, p < 0.001, for each standard deviation unit increase in PCA-SES1 score) in multivariable model accounting for age, household SES, study, BMI, fasting glucose, physical activity and diet. PCA-SES1 was not significantly associated with systolic BP among females (β -0.48 [-1.62, 0.66], p = 0.410) in a similar model. Associations for PCA-SES2 was assessed using linear splines to account for non-linear effects. The were no significant associations between systolic BP and PCA-SES2 among males. Among females, higher PCA-SES2 (i.e. lower SES) was associated with higher systolic BP at spline 2 [z-score -1 to 0] (β4.09 [1.49, 6.69], p = 0.002), but with lower systolic BP at spline 3 [z-core 0 to 1] (β-2.81 [-5.04, -0.59], p = 0.013). There were no significant associations between diastolic BP and PCA-SES1, but PCA-SES2 showed non-linear associations with diastolic BP particularly among males. Conclusion Higher neighbourhood SES was inversely associated with systolic BP among male Jamaican youth; there were non-linear associations between neighbourhood SES and systolic BP among females and for diastolic BP for both males and females.
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Affiliation(s)
- Trevor S Ferguson
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Novie O M Younger-Coleman
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Jasneth Mullings
- Health Research Resource Unit, Dean's Office, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica
| | - Damian Francis
- School of Health and Human Performance, Georgia College and State University, Milledgeville, GA, United States of America
| | - Lisa-Gaye Greene
- Mona GeoInformatics Institute, The University of the West Indies, Mona, Kingston, Jamaica
| | - Parris Lyew-Ayee
- Mona GeoInformatics Institute, The University of the West Indies, Mona, Kingston, Jamaica
| | - Rainford Wilks
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
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Sawyer AA, Pollock NK, Gutin B, Weintraub NL, Stansfield BK. Proportionality at birth and left ventricular hypertrophy in healthy adolescents. Early Hum Dev 2019; 132:24-29. [PMID: 30953878 PMCID: PMC7101490 DOI: 10.1016/j.earlhumdev.2019.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/22/2019] [Accepted: 03/26/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Perinatal growth has important implications for cardiac development. Low birth weight is associated with cardiovascular (CV) events and mortality, and animal studies have shown that fetal growth restriction is associated with cardiac remodeling in the perinatal period leading to a permanent loss of cardiomyocyte endowment and compensatory hypertrophy. AIMS To determine associations of birthweight (BW) and multiple proportionality indexes (body mass index (BMI); weight/length2 and Ponderal index (PI); weight/length3) at birth on one hand, with left ventricular (LV) structure and function during adolescence. SUBJECTS 379 healthy adolescents aged 14-18 years in Augusta, Georgia. OUTCOME MEASURES LV structure and function parameters, including intraventricular septal thickness in diastole (IVSd), LV internal dimension in diastole (LVIDd), LV internal diameter in systole (LVIDs), LV posterior wall thickness in diastole (LVPWd), relative wall thickness (RWT), midwall fractional shortening (MFS), and ejection fraction, were assessed by echocardiography. RESULTS When associations of birthweight, birth BMI, and birth PI with LV structure and function parameters were separately evaluated with linear regression adjusting for age, sex, race, Tanner stage, socioeconomic status, and physical activity, significant positive associations of BW with LVIDd (P = 0.004), birth BMI with LV mass index (P = 0.01), and birth PI with IVSd (P = 0.02), LVPWd (P = 0.03), and LV mass index (P = 0.002) were identified. When LV structure and function parameters were compared across PI tertiles, a significant U-shaped trend for LV mass index (Pquadratic = 0.04) was identified. CONCLUSIONS Our adolescent data suggest that proportionality at birth may identify associations between perinatal growth and cardiac remodeling independent of birthweight alone.
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Affiliation(s)
- Alexandra A. Sawyer
- Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Norman K. Pollock
- Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA, USA,Georgia Prevention Institute, Augusta University, Augusta, GA, USA
| | - Bernard Gutin
- Department of Nutrition, University of North Carolina, Chapel Hill, NC, USA
| | - Neal L. Weintraub
- Division of Cardiology, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA,Vascular Biology Center, Augusta University, Augusta, GA, USA
| | - Brian K. Stansfield
- Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA, USA,Vascular Biology Center, Augusta University, Augusta, GA, USA,Corresponding author at: Division of Neonatology, Department of Pediatrics, Medical College of Georgia at Augusta University, 1120 15th Street, BIW-6033, Augusta, GA 30912, USA. (B.K. Stansfield)
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Ferguson TS, Younger-Coleman NOM, Tulloch-Reid MK, Bennett NR, Rousseau AE, Knight-Madden JM, Samms-Vaughan ME, Ashley DE, Wilks RJ. Factors associated with elevated blood pressure or hypertension in Afro-Caribbean youth: a cross-sectional study. PeerJ 2018; 6:e4385. [PMID: 29456896 PMCID: PMC5815333 DOI: 10.7717/peerj.4385] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 01/29/2018] [Indexed: 12/20/2022] Open
Abstract
Background Although several studies have identified risk factors for high blood pressure (BP), data from Afro-Caribbean populations are limited. Additionally, less is known about how putative risk factors operate in young adults and how social factors influence the risk of high BP. In this study, we estimated the relative risk for elevated BP or hypertension (EBP/HTN), defined as BP ≥ 120/80 mmHg, among young adults with putative cardiovascular disease (CVD) risk factors in Jamaica and evaluated whether relative risks differed by sex. Methods Data from 898 young adults, 18–20 years old, were analysed. BP was measured with a mercury sphygmomanometer after participants had been seated for 5 min. Anthropometric measurements were obtained, and glucose, lipids and insulin measured from a fasting venous blood sample. Data on socioeconomic status (SES) were obtained via questionnaire. CVD risk factor status was defined using standard cut-points or the upper quintile of the distribution where the numbers meeting standard cut-points were small. Relative risks were estimated using odds ratios (OR) from logistic regression models. Results Prevalence of EBP/HTN was 30% among males and 13% among females (p < 0.001 for sex difference). There was evidence for sex interaction in the relationship between EBP/HTN and some of risk factors (obesity and household possessions), therefore we report sex-specific analyses. In multivariable logistic regression models, factors independently associated with EBP/HTN among men were obesity (OR 8.48, 95% CI [2.64–27.2], p < 0.001), and high glucose (OR 2.01, CI [1.20–3.37], p = 0.008), while high HOMA-IR did not achieve statistical significance (OR 2.08, CI [0.94–4.58], p = 0.069). In similar models for women, high triglycerides (OR 1.98, CI [1.03–3.81], p = 0.040) and high HOMA-IR (OR 2.07, CI [1.03–4.12], p = 0.039) were positively associated with EBP/HTN. Lower SES was also associated with higher odds for EBP/HTN (OR 4.63, CI [1.31–16.4], p = 0.017, for moderate vs. high household possessions; OR 2.61, CI [0.70–9.77], p = 0.154 for low vs. high household possessions). Alcohol consumption was associated with lower odds of EBP/HTN among females only; OR 0.41 (CI [0.18–0.90], p = 0.026) for drinking <1 time per week vs. never drinkers, and OR 0.28 (CI [0.11–0.76], p = 0.012) for drinking ≥3 times per week vs. never drinkers. Physical activity was inversely associated with EBP/HTN in both males and females. Conclusion Factors associated with EBP/HTN among Jamaican young adults include obesity, high glucose, high triglycerides and high HOMA-IR, with some significant differences by sex. Among women lower SES was positively associated with EBP/HTN, while moderate alcohol consumption was associated lower odds of EBP/HTN.
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Affiliation(s)
- Trevor S Ferguson
- Caribbean Institute for Health Research, University of the West Indies, Mona, Kingston, Jamaica
| | | | - Marshall K Tulloch-Reid
- Caribbean Institute for Health Research, University of the West Indies, Mona, Kingston, Jamaica
| | - Nadia R Bennett
- Caribbean Institute for Health Research, University of the West Indies, Mona, Kingston, Jamaica
| | - Amanda E Rousseau
- Caribbean Institute for Health Research, University of the West Indies, Mona, Kingston, Jamaica
| | | | | | - Deanna E Ashley
- School of Graduate Studies and Research, University of the West Indies, Mona, Kingston, Jamaica
| | - Rainford J Wilks
- Caribbean Institute for Health Research, University of the West Indies, Mona, Kingston, Jamaica
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