Role of Sex in the Association of Socioeconomic Status With Cardiovascular Health in Black Americans: The Jackson Heart Study.

Autor: Joseph JJ; The Ohio State University College of Medicine Columbus OH USA., Williams A; The Ohio State University College of Medicine Columbus OH USA., Azap RA; The Ohio State University College of Medicine Columbus OH USA., Zhao S; The Ohio State University College of Medicine Columbus OH USA., Brock G; The Ohio State University College of Medicine Columbus OH USA., Kline D; Department of Biostatistics and Data Science, Division of Public Health Sciences Wake Forest School of Medicine Winston-Salem NC USA., Odei JB; The Ohio State University College of Public Health Columbus OH USA., Foraker R; Department of Internal Medicine and Institute for Informatics Washington University in St. Louis School of Medicine St. Louis MO USA., Sims M; University of California Riverside CA USA., Brewer LC; Department of Cardiovascular Medicine Center for Health Equity and Community Engagement Research, Mayo Clinic Rochester MN USA., Gray DM 2nd; Elevance Health (formerly of The Ohio State University Wexner Medical Center) Indianapolis IN USA., Nolan TS; The Ohio State University College of Nursing Columbus OH USA.
Jazyk: angličtina
Zdroj: Journal of the American Heart Association [J Am Heart Assoc] 2023 Dec 05; Vol. 12 (23), pp. e030695. Date of Electronic Publication: 2023 Dec 01.
DOI: 10.1161/JAHA.123.030695
Abstrakt: Background: Socioeconomic status (SES) is associated with cardiovascular health (CVH). Potential differences by sex in this association remain incompletely understood in Black Americans, where SES disparities are posited to be partially responsible for cardiovascular inequities. The association of SES measures (income, education, occupation, and insurance) with CVH scores was examined in the Jackson Heart Study.
Methods and Results: American Heart Association CVH components (non-high-density-lipoprotein cholesterol, blood pressure, diet, tobacco use, physical activity, sleep, glycemia, and body mass index) were scored cross-sectionally at baseline (scale: 0-100). Differences in CVH and 95% CIs (Estimate, 95% CI) were calculated using linear regression, adjusting for age, sex, and discrimination. Heterogeneity by sex was assessed. Participants had a mean age of 54.8 years (SD 12.6 years), and 65% were women. Lower income, education, occupation (non-management/professional versus management/professional occupations), and insurance status (uninsured, Medicaid, Veterans Affairs, or Medicare versus private insurance) were associated with lower CVH scores (all P <0.01). There was heterogeneity by sex, with greater magnitude of associations of SES measures with CVH in women versus men. The lowest education level (high school) was associated with 8.8-point lower (95% CI: -10.2 to -7.3) and 5.4-point lower (95% CI: -7.2 to -3.6) CVH scores in women and men, respectively (interaction P =0.003). The lowest (<25 000) versus highest level of income (≥$75 000) was associated with a greater reduction in CVH scores in women than men (interaction P =0.1142).
Conclusions: Among Black Americans, measures of SES were associated with CVH, with a greater magnitude in women compared with men for education and income. Interventions aimed to address CVH through SES should consider the role of sex.
Databáze: MEDLINE
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