Prevalence of hypertension by duration and age at exposure to the stroke belt.


Journal Article

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.

Full Text

Cited Authors

  • Howard, VJ; Woolson, RF; Egan, BM; Nicholas, JS; Adams, RJ; Howard, G; Lackland, DT

Published Date

  • January 2010

Published In

Volume / Issue

  • 4 / 1

Start / End Page

  • 32 - 41

PubMed ID

  • 20374949

Pubmed Central ID

  • 20374949

Electronic International Standard Serial Number (EISSN)

  • 1878-7436

International Standard Serial Number (ISSN)

  • 1933-1711

Digital Object Identifier (DOI)

  • 10.1016/j.jash.2010.02.001


  • eng