The association between perceived neighborhood social cohesion and incident hypertension among older adults in the US Health and Retirement Study.

BACKGROUND

Despite the association between lower perceived neighborhood social cohesion (PNSC) and higher risk of hypertension, there is limited research on this relationship. This population-based study examined the association between PNSC and incident hypertension among a nationally representative population of older adults across racial and/or ethnic groups and sex.

METHODS

Data were obtained from 2,998 US older adult participants (mean age=62.5 years, SD=8.12) from the Health and Retirement Study. Normotensive participants at baseline (2006 or 2008) were assessed for hypertension incidence at 4- and 8-year follow-up visits. PNSC was classified into tertiles. Weighted Cox proportional hazards regression was used to estimate the association between PNSC and incident hypertension. Interaction terms (PNSC and racial and/or ethnic group, PNSC and sex) were included in models adjusted for appropriate covariates (sex, racial and/or ethnic group, education, body mass index, alcohol use, cigarette smoking status), and models were stratified by racial and/or ethnic group and sex.

RESULTS

Overall, 40.5% of the study population developed hypertension. Low perceived neighborhood social cohesion (versus high) was associated with increased hypertension risk (HR=1.22, 95% CI: 1.08-1.37). This association was the strongest among Black adults (HR=2.28, 95% CI: 1.23-4.25) and Black females (HR=3.40, 95% CI: 1.34-8.62), though the interaction terms were not statistically significant (p-values for interaction >0.05).

CONCLUSIONS

Individuals perceiving low neighborhood social cohesion may have increased hypertension risk, particularly among Black females. Future studies could test potential underlying mechanisms that explain this association and implement community-based interventions promoting cohesive communities as a potential strategy for reducing disparities in hypertension risk.