Abstract P395: Low Neighborhood Income is Associated With Increased Hypertension Incidence in the Reasons for Geographic and Racial Differences in Stroke Study

Introduction: Prior studies have investigated the relationship between neighborhood income and incident hypertension but have lacked participant-level details or studied specific subpopulations. We assessed the relationship between neighborhood income and incident hypertension accounting for individual level factors in the racially and geographically diverse REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Hypothesis: Low neighborhood income is associated with increased hypertension incidence. Methods: REGARDS recruited 30,239 white and black adults aged ≥45y from the contiguous US in 2003-7 with follow-up between 2013-6. We excluded individuals with baseline hypertension (≥130/80 mm Hg or using antihypertension medications, n=22,325), missing follow-up (n=3,365) and not residing at the same address for ≥5 years (n=1,075). Neighborhood income was measured within 1 and 5 km buffers around the participant’s home using a spatial overlay of census tract-level median household income, and then classified into tertiles. We used Poisson regression to calculate risk ratio for incident hypertension adjusting for demographic, socioeconomic, and health habit factors. Results: Among the 3,474 individuals (58% women, 24% black, mean age 62y), 1,499 individuals (43%) developed hypertension. After adjusting for individual-level risk factors, the incident rate ratio of hypertension for individuals living in low-income neighborhoods was 1.16 (95% CI 1.04, 1.31) and middle-income was 1.12 (95% CI 1.01, 1.25) as compared to high income, when neighborhood was defined as a 1 km buffer. The result was similar but not significant in middle-income for the 5 km buffer neighborhoods (Table 1). There were no significant interactions with age, gender, or race (p-interaction > 0.1). Conclusions: In REGARDS, neighborhood income was associated with incident hypertension. Understanding the specific social and environmental inequities associated with hypertension will require further study.