Document Detail

Prevalence of hypertension by duration and age at exposure to the stroke belt.
MedLine Citation:
PMID:  20374949     Owner:  NLM     Status:  MEDLINE    
Geographic variation in hypertension is hypothesized as contributing to the stroke belt, an area in the southeastern United States with high stroke mortality. No study has examined hypertension by lifetime exposure to the stroke belt. This association was studied in 19,385 participants in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, a national population-based cohort. Prevalent hypertension was defined as systolic blood pressure >/=140, diastolic blood pressure >/=90, or use of antihypertensive medications. Stroke belt exposure was assessed by residence at birth, currently, early childhood, adolescence, early adulthood, mid-adulthood, and recently. After adjustment for age, race, sex, physical activity level, body mass index, smoking, alcohol, education, and income, the prevalence of hypertension was significantly more strongly related (P < .0001) with lifetime exposure, adolescence, or early adulthood exposure than exposures at other times. Birthplace and current residence were independently associated with hypertension; however, lifetime, adolescence, or early adulthood exposures were more predictive than joint model with both birthplace and current residence. That adolescence and early adulthood periods are more predictive than residence in the stroke belt for most recent 20-year period suggests community and environmental strategies to prevent hypertension need to start earlier in life.
Virginia J Howard; Robert F Woolson; Brent M Egan; Joyce S Nicholas; Robert J Adams; George Howard; Daniel T Lackland
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of the American Society of Hypertension : JASH     Volume:  4     ISSN:  1933-1711     ISO Abbreviation:  J Am Soc Hypertens     Publication Date:    2010 Jan-Feb
Date Detail:
Created Date:  2010-04-08     Completed Date:  2010-06-10     Revised Date:  2013-07-29    
Medline Journal Info:
Nlm Unique ID:  101312518     Medline TA:  J Am Soc Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  32-41     Citation Subset:  IM    
Copyright Information:
Copyright 2010 American Society of Hypertension. All rights reserved.
Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294-0022, USA.
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MeSH Terms
African Continental Ancestry Group
Cohort Studies
Cross-Sectional Studies
European Continental Ancestry Group
Hypertension / epidemiology*
Logistic Models
Longitudinal Studies
Residence Characteristics*
Southeastern United States / epidemiology
Stroke / epidemiology*
Grant Support
1R01HL072377/HL/NHLBI NIH HHS; R01 HL072377-03/HL/NHLBI NIH HHS; U01 NS041588/NS/NINDS NIH HHS; U01 NS041588-08S1/NS/NINDS NIH HHS

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