Relationship between social support and incident hypertension in the Jackson Heart Study: a cohort study

Objectives: Social support may be an important mitigating factor against adverse cardiovascular outcomes by facilitating health-promoting behaviours or by buffering against the negative effects of stress. This study examined the association of social support with incident hypertension.

Design: Prospective cohort study.

Setting: We evaluated the association of social support with incident hypertension among participants in the Jackson Heart Study, a community-based cohort of African Americans.

Participants: This study included African American adults, who were free of hypertension at baseline (2000-2004). Functional social support, structural social support and satisfaction with social support were assessed at baseline among 1516, 1240 and 1503 participants, respectively.

Outcome measures: Incident hypertension was assessed at follow-up examinations in 2005-2008 and 2009-2013. Incident hypertension was defined by the first visit with systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg or self-reported antihypertensive medication use. Multivariable Poisson regression was used to estimate the association of baseline social support with incident hypertension, adjusting for relevant confounders.

Results: At baseline, the mean age of participants was 50 years and 64% were men. During a median follow-up time of 6.9 years, 54% of participants developed hypertension. A high level of functional social support was associated with lower risk of incident hypertension (incident rate ratio 0.64, (95% CI 0.41 to 0.97)), compared with a low level of functional social support. Level of structural social support and satisfaction with social support were not associated with hypertension risk.

Conclusions: These results suggest that greater functional support may be associated with a lower risk of incident hypertension.