Black-white blood pressure disparities: depressive symptoms and differential vulnerability to blood lead.
Black-white blood pressure disparities: depressive symptoms and differential vulnerability to blood lead.
复制标题
DOI：
10.1289/ehp.1104517
复制
发表时间：
2013-02
影响因子：
10.4
通讯作者：
Hu H
中科院分区：
文献类型：
--
作者：
Hicken MT;Gee GC;Connell C;Snow RC;Morenoff J;Hu H
背景：黑人的高血压发病率高于白人，但造成这些差异的原因尚不清楚。差异脆弱性（压力通过压力改变对环境危害影响的脆弱性）是环境健康领域的一个新兴概念，可能会导致这些差异。目的：我们研究了黑人和白人在血铅 (BPb) 和血压 (BP) 之间是否表现出不同的关联，以及抑郁症状是否可能发挥作用。方法：利用 2005-2008 年全国健康和营养检查调查，我们对 20 岁以上黑人和白人的种族/族裔、血压b 和抑郁症状之间的三向相互作用进行了血压回归。结果：黑人而非白人显示 BPb 与收缩压 (SBP) 之间呈正相关。黑人和白人之间这种关联的差异似乎是高度抑郁症状群体所特有的。在低抑郁症状组中，没有显着的黑白差异（β相互作用 = 0.9 mmHg；95% CI：–0.9，2.7）。然而，在患有高度抑郁症状的人中，黑人和白人的 SBP 分别增加 5.6 mmHg (95% CI: 2.0, 9.2) 和 1.2 mmHg (95% CI: –0.5, 2.9)，与 BPb 每次翻倍相关 (β相互作用 = 4.4 mmHg; 95% CI: 0.5, 8.3)。舒张压的结果模式相似。结论：我们的结果表明，抑郁症状可能导致 BPb 和 BP 之间的关联存在黑白差异。抑郁症状可能部分由社会心理压力引起。我们的研究结果支持这样的观点，即压力会增加对环境危害健康影响的脆弱性，并表明与压力相关的脆弱性可能是种族/民族健康差异的重要决定因素。
Background: Blacks have higher hypertension rates than whites, but the reasons for these disparities are unknown. Differential vulnerability, through which stress alters vulnerability to the effects of environmental hazards, is an emergent notion in environmental health that may contribute to these disparities. Objectives: We examined whether blacks and whites exhibit different associations between blood lead (BPb) and blood pressure (BP) and whether depressive symptoms may play a role. Methods: Using the National Health and Nutrition Examination Survey 2005–2008, we regressed BP on the three-way interaction among race/ethnicity, BPb, and depressive symptoms in blacks and whites ≥ 20 years of age. Results: Blacks but not whites showed a positive association between BPb and systolic blood pressure (SBP). The disparity in this association between blacks and whites appeared to be specific to the high depressive symptoms group. In the low depressive symptoms group, there was no significant black–white disparity (βinteraction = 0.9 mmHg; 95% CI: –0.9, 2.7). However, of those with high depressive symptoms, blacks and whites had 5.6 mmHg (95% CI: 2.0, 9.2) and 1.2 mmHg (95% CI: –0.5, 2.9) increases in SBP, respectively, in association with each doubling of BPb (βinteraction = 4.4 mmHg; 95% CI: 0.5, 8.3). The pattern of results was similar for diastolic blood pressure. Conclusions: Our results suggest that depressive symptoms may contribute to the black–white disparity in the association between BPb and BP. Depressive symptoms may result, in part, from psychosocial stress. Our results support the notion that stress increases vulnerability to the health effects of environmental hazards and suggest that stress-related vulnerability may be an important determinant of racial/ethnic health disparities.
登录
查看更多内容
影响因子：
6.9
作者：
Gavin AR;Walton E;Chae DH;Alegria M;Jackson JS;Takeuchi D
通讯作者：
Takeuchi D
影响因子：
10.4
作者：
Gee, Gilbert C;Payne-Sturges, Devon C
通讯作者：
Payne-Sturges, Devon C
影响因子：
5
作者：
Glass, Thomas A.;Bandeen-Roche, Karen;Schwartz, Brian S.
通讯作者：
Schwartz, Brian S.
影响因子：
5.4
作者：
Keyes, K. M.;Barnes, David M.;Bates, L. M.
通讯作者：
Bates, L. M.
影响因子：
10.4
作者：
Hu, H
通讯作者：
Hu, H