Religion and hypertension: testing alternative explanations among immigrants

In the Shadow of the Casinos: The Relationship between Religion and Health in Macau

Considerable research has shown that religion operates as a protective factor for one's health. However, there is still a lack of understanding of the mechanisms by which religion is linked to individual health and wellbeing, especially in predominantly secular societies. This study tried to address this gap by developing a theoretical model to examine how religiosity is related to life satisfaction and health perception in a non-Western culture. Macau, a Portuguese colony until 1999, remains a diversified culture because of its intermixed historical background from the East and the West. Through structural equation modeling, the analysis of data collected from a representative sample of Macau residents, using a multistage stratified sampling procedure, indicated a positive link between religiosity and health. Moreover, altruism and prejudice mediated a portion of the relationship between religiosity and health. Additionally, our results demonstrated that Macau residents who were more religious had a higher level of altruism and a lower level of prejudice. The link between religion and prejudice in Macau differs from that of many other cultures, indicating that the effect of religion on prejudice varies by cultural context. In sum, our study showed that even in the shadow of glittering casinos, religion is positively related to health.

Delivered from the Temptation of Smoking: An Examination of Religion and Health Behaviors of New US Immigrants

This study aims to contribute to the literature on smoking, religion, and health, by analyzing the associations between smoking and health of a sample of US immigrants, who represent many religions, ethnicities, and cultural backgrounds. Immigrants to the USA have better health outcomes than their native-born peers. This paper asserts that the pattern of smoking, influenced by immigrants' religion and religiosity, is key to understanding this phenomenon. This study investigates the relationship between religion and health of new legal immigrants to the USA by analyzing the New Immigrant Survey. The findings suggest that there is a protective relationship between immigrant religion and smoking patterns, both in likelihood of having ever smoked and in quitting smoking.

Religiosity/Spirituality and Physiological Markers of Health

The long-standing interest in the effects of religiosity and spirituality (R/S) on health outcomes has given rise to a large and diverse literature. We conducted a meta-analysis on research involving R/S and physiological markers of health to elucidate both the scope and mechanism(s) of this phenomenon. A combined analysis found a significant, but small, beneficial effect. Subgroup analyses found that some measures of both extrinsic and intrinsic religiosity were significantly associated with health. Several outcome measures, including blood pressure, C-reactive protein, and cardiovascular health markers, were significantly associated with R/S. Our findings suggest that R/S benefits health, perhaps through minimizing the disruptive effects of stress/depression on inflammation. We hope that researchers can use these results to guide efforts aimed at elucidating the true mechanism(s) linking religious/spiritual beliefs and physical health.

Correlation between religion and hypertension

The objectives of the study were to investigate the relationship between religion and hypertension, as well as the theoretical mechanism through which religion exerts effect on hypertension. A MEDLINE literature search was performed on articles describing religion and hypertension (N = 543) excluding unqualified ones such as those without expected information, those neither correcting confounding factors nor matching the comparison groups and those reporting repeated trials. Eight extra articles from references of reviews were added to the included studies. Finally, 79 articles were formerly evaluated. Briefly, there are limited trials on correlation between religion and hypertension and their results are inconsistent. First of all, longitudinal investigations, especially the high-quality ones, are deficient. Secondly, studies evaluating religion as an integral are scarce, although they can assess religions most comprehensively. Third, few studies use several religious measurements that represent distinct dimensions of religion. Moreover, divergence exists among diverse populations, even if they are assessed by the same indicator. In addition, 59% studies are concerned with an unspecified species of religion, and Christianity is studied the most among those with a specific category of religion. Finally, the possible mechanism underlying religion and hypertension is complex, which can partially explain the different results among various populations. Comprehensive evaluation of a specific religion should be encouraged. In addition, for a specific population, the correlation between religion and hypertension should be examined particularly, even if similar investigations in other populations have been conducted. Finally, more evidence focused on the effects of distinct religions/sects is also required.

Neighborhood conditions, religious coping, and uncontrolled hypertension

The purpose of this study is to see whether God-mediated control beliefs moderate the relationship between living in rundown neighborhoods and uncontrolled hypertension. God-mediated control refers to the belief that God will help people handle the stressors that arise in life. Data are provided by a nationwide survey of adults (N = 1919). Three ways of assessing uncontrolled hypertension are examined: a binary format contrasting people with and without uncontrolled hypertension, systolic and diastolic blood pressure scored continuously, and a four ordinal category scheme recommended by the American Heart Association. The data suggest that stronger God-mediated control beliefs moderate the relationship between neighborhood conditions and uncontrolled blood pressure when blood pressure is scored continuously and when the American Heart Association scheme are used as outcomes.

Spirituality, religiosity, aging and health in global perspective: A review

Persistent population aging worldwide is focusing attention on modifiable factors that can improve later life health. There is evidence that religiosity and spirituality are among such factors. Older people tend to have high rates of involvement in religious and/or spiritual endeavors and it is possible that population aging will be associated with increasing prevalence of religious and spiritual activity worldwide. Despite increasing research on religiosity, spirituality and health among older persons, population aging worldwide suggests the need for a globally integrated approach. As a step toward this, we review a subset of the literature on the impact of religiosity and spirituality on health in later life. We find that much of this has looked at the relationship between religiosity/spirituality and longevity as well as physical and mental health. Mechanisms include social support, health behaviors, stress and psychosocial factors. We identify a number of gaps in current knowledge. Many previous studies have taken place in the U.S. and Europe. Much data is cross-sectional, limiting ability to make causal inference. Religiosity and spirituality can be difficult to define and distinguish and the two concepts are often considered together, though on balance religiosity has received more attention than spirituality. The latter may however be equally important. Although there is evidence that religiosity is associated with longer life and better physical and mental health, these outcomes have been investigated separately rather than together such as in measures of health expectancy. In conclusion, there is a need for a unified and nuanced approach to understanding how religiosity and spirituality impact on health and longevity within a context of global aging, in particular whether they result in longer healthy life rather than just longer life.

Intrinsic Religiosity and Hypertension Among Older North American Seventh-Day Adventists

A unique lifestyle based on religious beliefs has been associated with longevity among North American Seventh-day Adventists (SDAs); however, little is known about how religion is directly associated with hypertension in this group. Identifying and understanding the relationship between hypertension and its predictors is important because hypertension is responsible for half of all cardiovascular-related deaths and one in every seven deaths in the USA. The relationship between intrinsic religiosity and hypertension is examined. Cross-sectional data from the Biopsychosocial Religion and Health Study (N = 9581) were used. The relationship between intrinsic religiosity and hypertension when controlling for demographics, lifestyle variables, and church attendance was examined using binary logistic regression. While lifestyle factors such as vegetarian diet and regular exercise were important predictors of reduced rates of hypertension, even after controlling for these, intrinsic religiosity was just as strongly related to lower hypertension rates as the lifestyle factors. This study is the first to examine the relationship between intrinsic religiosity and hypertension among North American SDAs and demonstrates that in addition to the positive effects of lifestyle choices on health noted in the group, religion may offer direct salutary effects on hypertension. This finding is particularly important because it suggests that religiosity and not just lifestyle is related to lower risk of hypertension, a leading cause of death in the USA.

Religion, spirituality, and health: the research and clinical implications

This paper provides a concise but comprehensive review of research on religion/spirituality (R/S) and both mental health and physical health. It is based on a systematic review of original data-based quantitative research published in peer-reviewed journals between 1872 and 2010, including a few seminal articles published since 2010. First, I provide a brief historical background to set the stage. Then I review research on R/S and mental health, examining relationships with both positive and negative mental health outcomes, where positive outcomes include well-being, happiness, hope, optimism, and gratefulness, and negative outcomes involve depression, suicide, anxiety, psychosis, substance abuse, delinquency/crime, marital instability, and personality traits (positive and negative). I then explain how and why R/S might influence mental health. Next, I review research on R/S and health behaviors such as physical activity, cigarette smoking, diet, and sexual practices, followed by a review of relationships between R/S and heart disease, hypertension, cerebrovascular disease, Alzheimer's disease and dementia, immune functions, endocrine functions, cancer, overall mortality, physical disability, pain, and somatic symptoms. I then present a theoretical model explaining how R/S might influence physical health. Finally, I discuss what health professionals should do in light of these research findings and make recommendations in this regard.

The interrelationship between hypertension and blood pressure, attendance at religious services, and race/ethnicity

The relationships between race/ethnicity and hypertension or blood pressure (BP), as well as frequency of religious services attendance and hypertension/BP are well documented. However, the association between these three factors is poorly understood. Using national data, this interrelationship was assessed in non-Hispanic whites and blacks, and Mexican-Americans (n = 12,488). Compared to those who never attended services, whites who attended services weekly had lower odds of hypertension, as did blacks who attended more than weekly. There was no relationship between attendance and hypertension among Mexican-Americans. Attendance was inversely related to systolic BP for all groups, but more so for whites and blacks compared to Mexican-Americans. These results further demonstrate the benefits of increased attendance at religious services on hypertension/BP, but suggest that these benefits were not as advantageous for all.

Spirituality and aging

Interest in spirituality and aging has increased recently, owing to overwhelming evidence of positive health outcomes linked to spirituality and religious participation. Increasing longevity in modern society puts spiritual needs of older adults at the forefront of societal priorities. Understanding individual spiritual perspectives becomes increasingly important, given the issues of loss, physical illness and mortality that are confronted in old age. There are multiple barriers to the proper assessment of spirituality in clinical practice and research (e.g., the lack of professional training for healthcare professionals, shortage of time and comfort for healthcare providers when discussing spiritual issues and needs). Integrating an individual’s spiritual practice into their healthcare can help shape personalized medical care for older adults and improve health outcomes. This article reviews literature and research on spirituality, as well as spiritual interventions and their putative neurobiological mechanisms in relation to aging, mental and physical health, and coping with death and dying.

Daily spiritual experiences, systolic blood pressure, and hypertension among midlife women in SWAN

BACKGROUND

There is reasonable evidence that religious beliefs and activities are associated with lower blood pressure and less hypertension. It is not known if daily spiritual experiences have similar effects.

PURPOSE

We examined the relationship between an eight-item version of the Daily Spiritual Experiences Scale (DSES) and systolic blood pressure (SBP) and hypertension.

METHODS

With data from 1,060 Caucasian and 598 African-American midlife women participating in Study of Women's Health Across the Nation, in race-stratified models, we used regression equations, logistic regression, and mixed effects regression to estimate the relationship between DSES group and SBP and hypertensive status.

RESULTS

We found little difference across DSES groups in adjusted mean SBP for either Caucasian or African-American women. Nor did DSES protect against 3-year increases in SBP, hypertensive status, or incident hypertension.

CONCLUSIONS

Daily spiritual experiences do not appear protective for SBP or hypertension in midlife women. Further research should examine factors that condition the religion-BP relationship.

Influence of prayer and prayer habits on outcome in patients with severe head injury

OBJECTIVES

The objective of the study is to evaluate the effect of prayers on the recovery of the unconscious patients admitted after traumatic brain injury.

MATERIAL AND RESULTS

A retrospective study of patients with severe head injury was conducted. The Glasgow Coma Scale and Glasgow Outcome Scale scores were examined along with age, gender, smoking, and alcohol intake. There were 13 patients who received prayer and 13 who did not receive prayer during the hospital stay with almost identical mean Glasgow Coma Scale score. The prayer group stayed in the hospital for more days (P = .03). On multivariate analysis, patients' age (P = .01), admission Glasgow Coma Scale score (P = .009), and prayer habits (P = .007) were significant factors.

CONCLUSION

Patients with prayers habits recovered better following severe head injury. The role of intercessory prayer needs further studies in larger groups.

An examination of the relationship between multiple dimensions of religiosity, blood pressure, and hypertension

Researchers have established the role of heredity and lifestyle in the occurrence of hypertension, but the potential role of psychosocial factors, especially religiosity, is less understood. This paper analyzes the relationship between multiple dimensions of religiosity and systolic blood pressure, diastolic blood pressure, and hypertension using data taken from the Chicago Community Adult Health Study, a probability sample of adults (N=3105) aged 18 and over living in the city of Chicago, USA. Of the primary religiosity variables examined here, attendance and public participation were not significantly related to the outcomes. Prayer was associated with an increased likelihood of hypertension, and spirituality was associated with increased diastolic blood pressure. The addition of several other religiosity variables to the models did not appear to affect these findings. However, variables for meaning and forgiveness were associated with lower diastolic blood pressure and a decreased likelihood of hypertension outcomes. These findings emphasize the importance of analyzing religiosity as a multidimensional phenomenon. This study should be regarded as a first step toward systematically analyzing a complex relationship.

The illness beliefs, perceptions, and practices of Filipino Americans with hypertension

PURPOSE

The purpose of this study was to describe the illness beliefs, perceptions, and practices of Filipino Americans (FAs) with hypertension (HTN) to reveal their explanatory models (EMs) of the illness.

DATA SOURCES

Audiotapes and transcripts of focus group interviews and observational notes were subjected to content analysis. Medical records and related empirical studies provided supporting data.

CONCLUSIONS

In general, the EMs of FAs with HTN correspond to the biomedical model in relation to causes, consequences, and treatment of HTN. However, in spite of this biomedical knowledge, FAs with HTN have difficulty maintaining the required lifestyle changes and adhering to the medication regimen to control their illness.

IMPLICATIONS FOR PRACTICE

It is important for NPs to assess the EMs of FAs with HTN, including their use of traditional folk remedies and practitioners of folk medicine. The challenge is to provide cardiovascular health promotion and education in a culturally sensitive, congruent, and tailored manner to FAs with HTN to help them control their illness.

Frequency of attendance at religious services, hypertension, and blood pressure: the Third National Health and Nutrition Examination Survey

OBJECTIVE

To test the hypothesis that frequency of attendance at religious services is inversely related to prevalence of hypertension and blood pressure level.

METHODS

In the Third National Health and Nutrition Examination Survey (NHANES III), 14,475 American women and men aged 20 years and over reported frequency of attendance at religious services, history of hypertension treatment, and had blood pressure (BP) measured.

RESULTS

The percentage reporting attending religious services weekly (52 times/yr) was 29 and more than weekly (>52 times/yr) was 10. Prevalence of hypertension (systolic BP > or = 140 or diastolic BP > or = 90 mm Hg or current use of blood pressure medication) was 21% in never at attenders, 19% in those attending less than weekly (1-51 times/yr), 26% in those attending weekly, and 26% in those attending more than weekly (p < .01). After controlling for sociodemographic and health variables, religious attendance was associated with reduced prevalence compared with nonattendance, significantly so for weekly (beta = -0.24; 95% confidence interval [CL], -0.37 to -0.11; p < .01) and more than weekly (beta = -0.33; 95% CL, -0.60 to -0.07; p < .05). No significant effect modification by gender or age was observed. Compared with never attenders, persons attending weekly had a systolic BP 1.46 mm Hg (95% CL 2.33, 0.58 mm Hg, p < .01) lower and persons attending >52 times/yr had systolic BP 3.03 mm Hg (95% CL 4.34, 1.72 mm Hg, p < .01) lower. No significant effect modification by gender was observed; these estimates are adjusted for a significant interaction between age and less than weekly attendance (1-51 times) (p < .05).

CONCLUSIONS

Compared with never attending, attendance at religious services weekly or more than weekly was associated with somewhat lower adjusted hypertension prevalence and blood pressure in a large national survey.

Religiosity/spirituality and health. A critical review of the evidence for biological pathways

The authors review evidence regarding the biological processes that may link religiosity/spirituality to health. A growing body of observational evidence supports the hypothesis that links religiosity/spirituality to physiological processes. Although much of the earliest evidence came from cross-sectional studies with questionable generalizability and potential confounding, more recent research, with more representative samples and multivariate analysis, provides stronger evidence linking Judeo-Christian religious practices to blood pressure and immune function. The strongest evidence comes from randomized interventional trials reporting the beneficial physiological impact of meditation (primarily transcendental meditation). Overall, available evidence is generally consistent with the hypothesis that religiosity/spirituality is linked to health-related physiological processes--including cardiovascular, neuroendocrine, and immune function--althogh more solid evidence is needed.

Claims about religious involvement and health outcomes

Claims about religion, spirituality, and health have recently appeared with increasing frequency, in both the popular media and professional journals. These claims have asserted that there are a great many studies in the literature that have examined relations between religious involvement and health outcomes and that the majority of them have shown that religious people are healthier. We examined the validity of these claims in two ways: (a) To determine the percentage of articles in the literature that were potentially relevant to such a claim, we identified all English-language articles with published abstracts identified by a Medline search using the search term religion in the year 2000, and (b) to examine the quality of the data in articles cited as providing supportfor such a claim, we examined all articles in the area of cardiovascular disease and hypertension cited by two comprehensive reviews of the literature. Of the 266 articles published in the year 2000 and identified by the Medline search, only 17% were relevant to claims of health benefits associated with religious involvement. About half of the articles cited in the comprehensive reviews were irrelevant to these claims. Of those that actually were relevant, many either had significant methodological flaws or were misrepresented, leaving only afew articles that could truly be described as demonstrating beneficial effects of religious involvement. We conclude that there is little empirical basis for assertions that religious involvement or activity is associated with beneficial health outcomes.

Religious involvement, spirituality, and medicine: implications for clinical practice

Surveys suggest that most patients have a spiritual life and regard their spiritual health and physical health as equally important. Furthermore, people may have greater spiritual needs during illness. We reviewed published studies, meta-analyses, systematic reviews, and subject reviews that examined the association between religious involvement and spirituality and physical health, mental health, health-related quality of life, and other health outcomes. We also reviewed articles that provided suggestions on how clinicians might assess and support the spiritual needs of patients. Most studies have shown that religious involvement and spirituality are associated with better health outcomes, including greater longevity, coping skills, and health-related quality of life (even during terminal illness) and less anxiety, depression, and suicide. Several studies have shown that addressing the spiritual needs of the patient may enhance recovery from illness. Discerning, acknowledging, and supporting the spiritual needs of patients can be done in a straightforward and noncontroversial manner. Furthermore, many sources of spiritual care (e.g., chaplains) are available to clinicians to address the spiritual needs of patients.