Psychological Resources and Incident Hypertension in the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Objective: Examining factors that may protect against the development of hypertension is critical, as hypertension is a major public health concern. We examined the individual and combined associations of psychological resources (optimism and mastery) on incident hypertension over 15 years. Method: We used data from four exams of the Coronary Artery Risk Development in Young Adults (CARDIA) study over 15 years (CARDIA exam years 15-30). Optimism and mastery were standardized to a z-score separately and summed to generate a psychological resources score. We examined the incidence of hypertension (stages 1 and 2; systolic blood pressure [SBP] = 130 mmHg or diastolic blood pressure [DBP] = 80 mmHg) and stage 2 hypertension (SBP = 140 mmHg or DBP = 90 mmHg) among participants without hypertension at baseline. Multivariable logistic regressions adjusted for sociodemographic factors, behavioral factors, and depressive symptoms. Results: Of 2,927 participants, 58% were women, 42% were Black, and the average age at the study baseline was 40 years (3.63). A higher psychological resources score was associated with lower odds of developing hypertension (stages 1 and 2; odds ratio [OR]: 0.89, 95% CI [-0.21, -0.03], p < .01) and stage 2 hypertension (OR: 0.88, [-0.21, -0.04], p < .01), after adjustment for sociodemographic factors. However, following adjustment for behavioral factors and depressive symptoms, the associations for hypertension (stages 1 and 2) and stage 2 hypertension were no longer statistically significant. Conclusions: Greater psychological resources are associated with lower odds of hypertension. Associations were attenuated after additional adjustment for behavioral factors, indicating these factors may be important confounders or mediators.