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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2006.088799v1 97/12/2253    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Sweet, E. Articles by Liu, K. PubMed PubMed Citation Articles by Sweet, E. Articles by Liu, K. Related Collections Cardiovascular Disease African Americans/Blacks Socioeconomic Factors

Elizabeth Sweet, BA, Thomas W. McDade, PhD, Catarina I. Kiefe, MD, PhD and Kiang Liu, PhD

Elizabeth Sweet is a PhD candidate in the Department of Anthropology, Northwestern University, Evanston, Ill. Thomas W. McDade is with the Department of Anthropology, Center on Social Disparities and Health, and the Institute for Policy Research, Northwestern University, Evanston. Catarina I. Kiefe is with the Birmingham Veterans Affairs Medical Center, Birmingham, Ala, and the Division of Preventive Medicine, University of Alabama, Birmingham. Kiang Liu is with the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Evanston.

Correspondence: Requests for reprints should be sent to Thomas W. McDade, PhD, Department of Anthropology, Northwestern University, 1810 Hinman Ave, Evanston, IL 60208 (e-mail: t-mcdade{at}northwestern.edu).

Objectives. We explored how income and skin color interact to influence the blood pressure of African American adults enrolled in the longitudinal Coronary Artery Risk Development in Young Adults (CARDIA) Study.

Methods. Data were derived from 1893 African American CARDIA year-15 participants who had undergone skin reflectance assessments at year 7. We adjusted for age, gender, body mass index, smoking status, and use of antihypertensive medication to examine whether year-15 self-reported family incomes, in interaction with skin reflectance, predicted blood pressure levels.

Results. Mean systolic and diastolic blood pressure levels were 117.1 (±16.07) and 76.9 (±12.5) mm Hg, respectively. After adjustment, the interaction between skin reflectance and income was significantly associated with systolic blood pressure (P< .01). Among lighter-skinned African Americans, systolic pressure decreased as income increased (b= –1.15, P<.001); among those with darker skin, systolic blood pressure increased with increasing income (b=0.10, P=.75).

Conclusions. The protective gradient of income on systolic blood pressure seen among African Americans with lighter skin is not observed to the same degree among those with darker skin. Psychosocial stressors, including racial discrimination, may play a role in this relationship.