تاثیر آموزش و پرورش و فقر محلهای بر روی پاسخ های پرسور به فنیل افرین در آمریکایی های آفریقایی تبار و قفقاز آمریکایی

Although neighborhood disadvantage has been linked to the development of cardiovascular disease, the mechanism through which living in impoverished neighborhoods is associated with poor cardiovascular health is not well understood. Additionally, it is not clear whether individual socioeconomic status (SES) interacts with neighborhood factors to influence cardiovascular outcomes. Using multilevel modeling, we examined the interaction between neighborhood poverty and individual SES on pressor responses to an alpha agonist, phenylephrine (PE), in an adult sample of 105 African-Americans and 106 Caucasian-Americans. Neighborhood poverty was assessed using census block data gathered from the Census Bureau. Education and occupation were used to assess individual SES. Pressor responsiveness was calculated as the systolic and diastolic blood pressure (BP) response to a 100-μg PE bolus administered intravenously. There was a significant interaction between education and neighborhood poverty on pressor responses. Higher education was associated with smaller BP responses to PE; but only in individuals who lived in neighborhoods in which less than 5% of the residents lived below the poverty line. Occupation was unrelated to pressor responses to PE. These results suggest that neighborhood characteristics play an important role in cardiovascular functioning.

Neighborhood disadvantage has been linked to the development of cardiovascular disease. There is a higher incidence of cardiovascular disease (CVD) in lower SES individuals compared to higher SES individuals (Singh and Siahpush, 2002). Additionally, neighborhood poverty is associated with more CVD risk factors, such as diabetes, tobacco smoking, and obesity (Chen and Paterson, 2006; Cubbin, Hadden, and Winkleby, 2001). Epidemiological studies using census data reveal higher rates of hypertension and stroke among individuals who live in low SES neighborhoods (Anand et al., 2007, Bravata et al., 2005, Loucks et al., 2007, McClellan, 2005 and Nzerue et al., 2002). Additionally, recent evidence suggests that neighborhood disadvantage is associated with carotid artery atherosclerosis in untreated hypertensives (Petersen et al., 2006).