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Psychosocial correlates of apparent treatment-resistant hypertension in the Jackson Heart Study

A J Shallcross1, M Butler1, R M Tanner2

  • 1Department of Population Health, New York University School of Medicine, New York, NY, USA.

Journal of Human Hypertension
|January 27, 2017
PubMed

Insights

Apparent treatment-resistant hypertension (aTRH) is more common in African Americans. A larger social network was linked to a lower prevalence of aTRH, suggesting it may be a modifiable factor.

Area of Science:

  • Cardiovascular Health
  • Public Health
  • Social Determinants of Health

Background:

  • Apparent treatment-resistant hypertension (aTRH) is linked to poor cardiovascular outcomes.
  • aTRH disproportionately affects African Americans, a population group with a high prevalence of hypertension.
  • Understanding psychosocial factors associated with aTRH is crucial for targeted interventions.

Purpose of the Study:

  • To investigate the relationship between psychosocial factors and aTRH in a population-based cohort of African Americans with hypertension.
  • To identify potential modifiable determinants of aTRH within this demographic.

Main Methods:

  • The Jackson Heart Study cohort included 1392 participants with treated hypertension and self-reported medication adherence.
  • aTRH was defined by uncontrolled blood pressure despite medication.
  • Poisson regression was used to assess associations between psychosocial factors (chronic stress, depressive symptoms, social support, social network) and aTRH.

Main Results:

  • The prevalence of aTRH was 15.1%.
  • Participants with aTRH reported significantly smaller social networks (fewer sources of regular social contact) compared to those without aTRH (P<0.01).
  • Each additional unique source of social contact was associated with a 19% (age-, sex-adjusted) and 13% (fully adjusted) lower prevalence of aTRH.

Conclusions:

  • Social network size emerged as a significant independent correlate of aTRH in African Americans.
  • A broader social network may be a protective factor against aTRH.
  • Further research into social network interventions for aTRH management in African Americans is warranted.

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