High caregiving stress among young Black women tied to increased hypertension incidence
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Key takeaways:
- During follow-up, 43.5% of Black women aged 21 to 44 years developed hypertension.
- High caregiving stress remained associated with incident hypertension after adjustment for relevant covariates.
High caregiving stress was associated with incident hypertension among a cohort of reproductive-age Black women, according to study findings published in Hypertension.
“While we know that caregiving strain can lead to burnout and negatively impact psychological health in reproductive-age women, the relationship between caregiving strain and development of hypertension has not been extensively studied,” Milla Arabadjian, PhD, assistant professor in the department of foundations of medicine at NYU Grossman Long Island School of Medicine, told Healio. “Our study is one of the first to provide evidence of negative physical health impacts from caregiver strain in this age group of women.”
To determine whether caregiving stress and being a caregiver for high-needs dependents were associated with incident hypertension, Arabadjian and colleagues conducted a secondary analysis of data from 453 Black women aged 21 to 44 years who participated in the Jackson Heart Study.
Women included in this cohort were those who had a BP less than 140/90 mm Hg and were not taking antihypertensive medication at baseline.
The researchers used a single question from the Perceived Stress Scale to assess caregiving stress: “Over the past 12 months, how much stress did you experience related to caring for others?” They measured participants’ responses on a 4-point Likert scale, with 1 being not stressful and 4 being very stressful.
Additionally, they assessed caregiving status by asking participants, “During the past year, how much time did you spend caring for children under 5 years of age or for a disabled child or elderly person?” Those who responded that they spent 1 or more hours per week caring for high-needs dependents were categorized as caregivers for high-needs dependents.
Caregiving stress and high BP among Black women
The researchers defined incident hypertension as a systolic BP of 140 mm Hg or higher, diastolic BP of 90 mm Hg or higher, or self-reported use of antihypertensive medication at follow-up exams in 2005 to 2008 and 2009 to 2013.
During a median follow-up of 7.4 years, 43.5% of participants developed hypertension, according to the researchers.
“It was surprising and notable that, in this cohort, more than four of 10 women developed hypertension in the median follow-up period of 7 years,” Arabadjian told Healio. “This means that many of the women developing hypertension were still in their reproductive years, which has implications for long-term heart disease risk and potential for adverse pregnancy outcomes.”
Participants with moderate or high caregiving stress had a higher incidence of hypertension compared with those with low or no caregiving stress (51.7% vs. 40.6%), according to the study.
Additionally, the researchers observed that higher caregiving stress remained associated with incident hypertension after adjustment for clinical and sociodemographic characteristics, health behaviors and depressive symptoms (HR = 1.39; 95% CI, 1.01-1.94).
The researchers noted that being a caregiver for high-needs dependents was not associated with incident hypertension (adjusted HR = 0.88; 95% CI, 0.64-1.21).
Important to ‘understand sources of chronic stress’
“The findings underscore the need for everyday clinicians to diligently and proactively screen reproductive-age women for hypertension,” Arabadjian told Healio. “It’s also important for clinicians to understand sources of chronic stress in this age group and the links between stress and adverse health outcomes in order to effectively link patients to needed resources, from educating and counseling on stress management and lifestyle behaviors to mental health services referrals.”
Arabadjian and colleagues noted several study limitations, including that they could not distinguish by type of high-needs caregiving and the number of high needs dependents per caregiver.
“Future studies should focus on examining chronic sources of stress and social contributors for hypertension among reproductive-age women, particularly minoritized and socially vulnerable younger women, in order to improve prevention strategies to reduce hypertension and subsequent high lifetime cardiovascular risk among this group,” Arabadjian told Healio.
For more information:
Milla Arabadjian, PhD, can be reached at 101 Mineola Blvd, Mineola, NY 11501.
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