Mediation of risk factors for high blood pressure in four racial and ethnic populations.

IF 1.2 4区 社会学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Anna Zamora-Kapoor, Luciana Hebert, Pranav Mellacheruvu, Dedra Buchwald, Ka'imi Sinclair
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Abstract

This study evaluated the extent to which body mass index (BMI) mediates associations between risk factors and incident high blood pressure in American Indians and Alaska Natives (AI/ANs), Non-Hispanic Whites (NHWs), Non-Hispanic Blacks (NHBs) and Hispanics. There were 7,793 participants from the National Longitudinal Study of Adolescent to Adult Health: 312 AI/ANs, 1,091 Hispanics, 1,567 NHBs and 4,823 NHWs. Risk factors for high blood pressure included adolescent BMI, TV watching, fast-food consumption, smoking, parental obesity, parental educational attainment and financial instability. Relative risk regression models stratified by race/ethnicity were used to examine associations between risk factors and incident high blood pressure. Path analysis was used to assess mediation by BMI. Female sex was a protective factor against high blood pressure, and higher BMI was a risk factor in all populations. Smoking increased high blood pressure risk in AI/ANs (Incident Rate Ratio [IRR]: 1.14, 95% CI: 1.02-1.27), but not in other groups. BMI partially mediated the effect of parental obesity on high blood pressure in NHWs and completely mediated the effect of parental obesity in NHBs. In AI/ANs and Hispanics, BMI did not mediate the relationship between incident high blood pressure and any risk factor. This study assessed the extent to which BMI mediates risk factors for high blood pressure in four populations, and showed important differences across populations. Further research is needed to improve knowledge about relationships between BMI, risk factors and incident high blood pressure, and their potential variability by race/ethnicity.

四种种族和民族人群高血压风险因素的中介作用。
本研究评估了身体质量指数(BMI)在多大程度上介导了美国印第安人和阿拉斯加原住民(AI/ANs)、非西班牙裔白人(NHWs)、非西班牙裔黑人(NHBs)和西班牙裔美国人的高血压发病风险因素之间的关联。全国青少年到成人健康纵向研究 "共有 7793 名参与者:其中包括 312 名美国原住民/印第安人、1,091 名西班牙裔、1,567 名非西班牙裔黑人和 4,823 名非西班牙裔妇女。高血压的风险因素包括青少年体重指数、看电视、吃快餐、吸烟、父母肥胖、父母受教育程度和经济不稳定。采用按种族/族裔分层的相对风险回归模型来研究风险因素与高血压发病率之间的关联。路径分析用于评估体重指数的中介作用。在所有人群中,女性是高血压的保护因素,而较高的体重指数则是风险因素。吸烟会增加美国原住民/印第安人的高血压风险(发病率比 [IRR]: 1.14, 95% CI: 1.02-1.27),但在其他群体中不会。体重指数(BMI)部分调节了父母肥胖对非高危人群高血压的影响,完全调节了父母肥胖对非高危人群高血压的影响。在美国原住民/印第安人和西班牙裔人中,BMI 并不介导高血压事件与任何风险因素之间的关系。这项研究评估了四种人群中 BMI 对高血压风险因素的中介作用程度,并显示出不同人群之间的重要差异。要进一步了解 BMI、风险因素和高血压发病率之间的关系,以及它们在不同种族/族裔中的潜在差异,还需要进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.50
自引率
11.10%
发文量
43
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