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(Circulation. 2002;106:703.)
© 2002 American Heart Association, Inc.

Clinical Investigation and Reports

Socioeconomic Disadvantage and Change in Blood Pressure Associated With Aging

Ana V. Diez Roux, MD, PhD; Lloyd Chambless, PhD; Sharon Stein Merkin, MHS; Donna Arnett, PhD; Marsha Eigenbrodt, MD, MPH; F. Javier Nieto, MD, PhD; Moyses Szklo, MD, DrPH; Paul Sorlie, PhD

From the Division of General Medicine, Columbia College of Physicians and Surgeons (A.V.D.R., S.S.M.), New York, NY; the Department of Biostatistics, University of North Carolina (L.C.), Chapel Hill; the Division of Epidemiology, University of Minnesota (D.A.), Minneapolis; the Department of Epidemiology, University of North Carolina (M.E.), Chapel Hill; the Department of Epidemiology, Johns Hopkins University (F.J.N., M.S.), Baltimore, Md; and the Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute (P.S.), Bethesda, Md.

Reprint requests to Ana V. Diez Roux, Division of General Medicine, 622 W 168th St, PH9 East Rm105, New York, NY 10032. E-mail ad290{at}columbia.edu

Background— Few studies have examined how the longitudinal change in blood pressure associated with aging differs across social groups within industrialized countries.

Methods and Results— Data from the Atherosclerosis Risk In Communities Study were used to investigate differences in the incidence of hypertension and in aging-related changes in blood pressure by neighborhood and individual socioeconomic factors over a 9-year follow-up. Disadvantage in multiple socioeconomic dimensions was associated with the greatest risk of developing hypertension (age- and sex-adjusted hazard ratio [HR] and 95% CI: HR 1.95, 95% CI 1.38 to 2.75 in whites and HR 1.43, 95% CI 0.96 to 2.13 in blacks). Aging-related increases in systolic blood pressure were inversely associated with socioeconomic position in whites (mean [SEM] 5-year increase in systolic blood pressure 7 [0.7] mm Hg in the most disadvantaged category and 5.4 [0.4] mm Hg in the most advantaged category). In whites, low socioeconomic position was also associated with more rapid declines in diastolic blood pressure after 50 years of age. Socioeconomic differences in hypertension incidence and changes in systolic blood pressure were reduced after adjustment for baseline blood pressure.

Conclusion— The change in blood pressure associated with aging varies by social groups within the United States.

Key Words: blood pressure • hypertension • aging • risk factors

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