Multiple social roles and blood pressure of black and white women: The CARDIA study

Purpose: Multiple social roles in women - marriage, motherhood, and work - are viewed by some as beneficial, by others as stressful, and by others as reflecting a balance between benefits and stress. The impact of social roles on blood pressure (BP) were analyzed in 1,473 blacks and 1,301 whites, ages 18-30, by analysis of covariance (ANCOVA), in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Findings: Differential BP by educational level in black women with multiple roles: Better educated black women with multiple roles had lower mean]BP than those in fewer roles (-1.3 to -8.0 mmHg systolic); less well-educated women generally had higher mean BP (+0.6 to +3.1 mmHg systolic). In whites, there was no consistent association between multiple roles and BP. In whites, marriage and motherhood were each independently related to BP regardless of education; marriage with higher BP (+0.1 to +2.4 mmHg) and motherhood with lower BP (-0.4 to -2.6 mmHg). In blacks, marriage, motherhood, and education were not independent; married mothers had higher BP (+2.2 mmHg) than single mothers among the less well educated, whereas among the better educated, married mothers had lower BP (-2.3 mmHg). In better educated blacks only, BP was lower for working women. Conclusion: Explanations for these associations remain to be explored. If social roles affect BP, the findings suggest the effects differ by race and, in blacks, by education.