Sex differences in the association of childhood socioeconomic status with adult blood pressure change: The CARDIA study

OBJECTIVE: To examine sex differences in the relation of childhood socioeconomic status (CSES) to systolic (SBP) and diastolic blood pressure (DBP) trajectories during 15 years, spanning young (mean [M] [standard deviation {SD}] = 30 [3] years) and middle (M [SD] = 45 [3] years) adulthood, independent of adult SES. METHODS: A total of 4077 adult participants reported father's and mother's educational attainments at study enrollment (Year 0) and own educational attainment at enrollment and at all follow-up examinations. Resting BP also was measured at all examinations. Data from examination Years 5 (when participant M [SD] age = 30 [3] years), 7, 10, 15, and 20 are examined here. Associations of own adult (Year 5), mother's, and father's educations with 15-year BP trajectories were examined in separate multilevel models. Fully controlled models included time-invariant covariates (age, sex, race, recruitment center) and time-varying covariates that were measured at each examination (marital status, body mass, cholesterol, oral contraceptives/ hormones, and antihypertensive drugs). Analyses of parental education controlled for own education. RESULTS: When examined without covariates, higher education-own (SBP γ =-0.03, DBP γ =-0.03), mother's (SBP γ =-0.02, DBP γ =-0.02), and father's (SBP γ =-0.02, DBP γ =-0.01)-were associated with attenuated 15-year increases in BP (p <.001). Associations of own (but not either parent's) education with BP trajectories remained independent of standard controls. Sex moderated the apparent null effects of parental education, such that higher parental education-especially mother's, predicted attenuated BP trajectories independent of standard covariates among women (SBP γ =-0.02, p =.02; DBP γ =-0.01, p =.04) but not men (SBP γ = 0.02, p =.06; DBP γ = 0.005, p =.47; p interaction SBP <.001, p interaction DBP =.01). CONCLUSIONS: Childhood socioeconomic status may influence women's health independent of their own adult status. ABBREVIATIONS: BMI = body mass indexBP = blood pressureCARDIA = Coronary Artery Risk Development in Young Adults StudyCSES = childhood socioeconomic statusCVD = cardiovascular diseaseDBP = diastolic blood pressureOC/HRT = oral contraceptives/hormone replacement therapySBP = systolic blood pressureSES = socioeconomic status.