Examining the Association Between Marital Status and Cardiovascular Disease Risk in Early Middle Aged African-American Women Público

Abstract

African-American women are disproportionately burdened by cardiovascular disease (CVD) morbidity and mortality when compared to other race-gender groups. Common health-related factors such as obesity or socioeconomic status do not explain the excess risk of CVD in this group. So, social influences may be at play. Being married is a social factor that has been linked to lower cardiovascular disease risk; however, this association has been understudied for African-American women, especially in early midlife, when elevated CVD risk is most pronounced. Utilizing data from 414 African-American women aged 30-46, we examined associations between marital status and CVD risk. CVD risk was assessed by averaged ambulatory blood pressure (ABP) measurements. For exploratory purposes, we also assessed cohabitation status and CVD risk.

Results indicated that unmarried African-American women did not have significantly different CVD risk (as measured by ABP outcomes) when compared to married African-American women. In linear regression models adjusted for age, unmarried women had slightly higher levels of daytime systolic BP (β =1.3, SE=1.3, p=0.33) and nighttime systolic BP (β =1.9, SE=1.3, p=0.13) compared to married women, but these results were not significant. Even after adjusting for education, employment, family income and size, BMI, smoking, anti-hypertensive medication, and depressive symptoms, this trend of nonsignificant results persisted. This pattern also occurred for daytime and nighttime DBP throughout all models.

Findings also suggested that cohabiting African-American women tended to have higher BP measurements than married African-American women, and this was especially true for those who were college-educated. In linear regression models, associations for college-educated cohabiting women and daytime diastolic BP were significant throughout all models even after adjusting for age, employment, family income and size, BMI, smoking, anti-hypertensive medication, and depressive symptoms (β = 6.4, SE=2.6, p=0.02). Similar results occurred after these adjustments for daytime systolic BP (β = 7.5, SE=3.7, p=0.04) and nighttime diastolic BP (β = 5.3, SE=2.5, p=0.03). Therefore, in this group of early middle-aged African-American women, cohabitation status but not marital status was associated with CVD risk.

Table of Contents

1.Abstract

2.Introduction

3.Literature Review

4.Methods

5.Results

6.Discussion

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Palabra Clave	Cardiovascular disease risk African-American women Marital status Cohabitation status
Committee Chair / Thesis Advisor	Dr. Tené Lewis, Emory University

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