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Sex Differences in the Association of Childhood Socioeconomic Status With Adult Blood Pressure Change

The CARDIA Study

Janicki-Deverts, Denise, PhD; Cohen, Sheldon, PhD; Matthews, Karen A., PhD; Jacobs, David R. Jr, PhD

doi: 10.1097/PSY.0b013e31825e32e8
Original Articles

Objective To examine sex differences in the relation of childhood socioeconomic status (CSES) to systolic (SBP) and diastolic blood pressure (DBP) trajectories during 15 years, spanning young (mean [M] [standard deviation {SD}] = 30 [3] years) and middle (M [SD] = 45 [3] years) adulthood, independent of adult SES.

Methods A total of 4077 adult participants reported father’s and mother’s educational attainments at study enrollment (Year 0) and own educational attainment at enrollment and at all follow-up examinations. Resting BP also was measured at all examinations. Data from examination Years 5 (when participant M [SD] age = 30 [3] years), 7, 10, 15, and 20 are examined here. Associations of own adult (Year 5), mother’s, and father’s educations with 15-year BP trajectories were examined in separate multilevel models. Fully controlled models included time-invariant covariates (age, sex, race, recruitment center) and time-varying covariates that were measured at each examination (marital status, body mass, cholesterol, oral contraceptives/hormones, and antihypertensive drugs). Analyses of parental education controlled for own education.

Results When examined without covariates, higher education — own (SBP γ = −0.03, DBP γ = −0.03), mother’s (SBP γ = −0.02, DBP γ = −0.02), and father’s (SBP γ = −0.02, DBP γ = −0.01) — were associated with attenuated 15-year increases in BP (p < .001). Associations of own (but not either parent’s) education with BP trajectories remained independent of standard controls. Sex moderated the apparent null effects of parental education, such that higher parental education—especially mother’s, predicted attenuated BP trajectories independent of standard covariates among women (SBP γ = −0.02, p = .02; DBP γ = −0.01, p = .04) but not men (SBP γ = 0.02, p = .06; DBP γ = 0.005, p = .47; p interaction SBP < .001, p interaction DBP = .01).

Conclusions Childhood socioeconomic status may influence women’s health independent of their own adult status.

Abbreviations BMI = body mass index

BP = blood pressure

CARDIA = Coronary Artery Risk Development in Young Adults Study

CSES = childhood socioeconomic status

CVD = cardiovascular disease

DBP = diastolic blood pressure

OC/HRT = oral contraceptives/hormone replacement therapy

SBP = systolic blood pressure

SES = socioeconomic status

From the Department of Psychology (D.J.-D., S.C.), Carnegie Mellon University; Department of Psychiatry (K.A.M.), University of Pittsburgh, Pittsburgh, Pennsylvania; Division of Epidemiology and Community Health (D.R.J.), School of Public Health, University of Minnesota, Minneapolis, Minnesota; and Department of Nutrition (D.R.J.), University of Oslo, Oslo, Norway.

Address correspondence and reprint requests to Denise Janicki-Deverts, PhD, Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213. E-mail:

Work on this article was supported (or partially supported) by contracts from the University of Alabama at Birmingham, Coordinating Center, N01-HC-95095; the University of Alabama at Birmingham, Field Center, N01-HC-48047; the University of Minnesota, Field Center and Diet Reading Center (Year 20 Exam), N01-HC-48048; Northwestern University, Field Center, N01-HC-48049; and the Kaiser Foundation Research Institute, N01-HC-48050.

Preparation of the article was also facilitated by the Pittsburgh Mind-Body Center (HL076852, R24HL076858) and R01-HL095296-01 from the National Heart, Lung, and Blood Institute.

Received for publication June 6, 2011; revision received March 19, 2012.

Copyright © 2012 by American Psychosomatic Society
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