EPIDEMIOLOGY

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The purpose of this project is to perform population-based epidemiologic research on the relationships among social factors and hypertension among older African Americans. In line with the theoretical model that integrates center activities, the social factors examined will include socioeconomic status, chronic stress, stressful life events, religion, and social support. Dependent variables include the prevalence and incidence of hypertension, therapeutic control of hypertension, and use of antihypertensive medications. There are three specific aims: (1) to perform population-based epidemiologic research examining the relationships among social factors and hypertension among older African Americans, (2) to assemble a variety of data bases appropriate for investigations of hypertension among older African Americans, and (3) to develop a network of investigators committed to epidemiologic research on hypertension and social factors. Special efforts will be made to involve young investigators and minority investigators in this network. Duke EPESE data will be the primary data used. These data are nearly ideal for the proposed research because (a) the data are from a representative sample of a defined geographic area, (b) EPESE data focus on chronic diseases, including hypertension, and social factors expected to influence disease onset and course, (c) the sample includes a large number of African Americans [N = 2,261 (55%) at baseline], and (d) there are seven years of longitudinal data on EPESE respondents. Other data sets will be used to replicate results, examine middle-aged as well as older African Americans, and investigate variables that are not included in the Duke EPESE data. Primary methods of analysis are multivariate models. Regression techniques will be used to examine the relationships between social factors and hypertensive outcomes. Proportional hazard models will be used to model the effects of time-varying predictors.