The Association Between Perceived Stress and Hypertension Among Asian Americans: Does Social Support and Social Network Make a Difference?

Abstract

Background: Prior research suggests that stress plays role in the etiology and progression of hypertension. To lend a more accurate depiction of the underlying mechanisms between stress and hypertension, this study aims to assess the associations between perceived stress and hypertension across varying levels of social support and social network among Asian Americans. Methods: We conducted a cross-sectional study using data on 530 Chinese, Korean and Vietnamese Americans recruited from a liver cancer prevention program in the Washington D.C.-Baltimore metropolitan area. Results: Hypertension prevalence was 29.1%. Individuals with high perceived stress were 61% more likely to have hypertension compared to those with low levels of perceived stress (Odds Ratio (OR): 1.61, 95% Confidence interval (CI): 1.15, 2.46). There was no evidence that social support and social network acted as effect modifiers. Social support had a direct beneficial effect on hypertension, irrespective of whether individuals were under stress. The relationship between perceived stress and hypertension was modified by gender and ethnicity whereby a significant positive association was only observed among male or Chinese participants. Conclusion: Our study highlights the importance of understanding the associations between stress, social support, and hypertension among Asian American subgroups. Findings from the study can be used to develop future stress management interventions, and incorporate culturally and linguistically appropriate strategies into community outreach and education to decrease hypertension risk within the Asian population.

Socioeconomic and behavioral determinants of cardiovascular diseases among older adults in Belgium and France: A longitudinal analysis from the SHARE study

“…et al, which indicate low social support is associated with coronary heart diseases [37]. Several studies also documented the role of social support in CVD incidence and mortality [38][39][40]. Both objective social isolation and the subjective perception of being isolated have been shown to be associated with a higher rate of CVD [41,42].…”

Predictors of Psychological Stress in Bhutanese Hypertensive Adults

“…9 Similar to the finding of this study, previous studies have also observed a higher number of female patients. 9,21 The majority of the participants in this study were either overweight or obese (79.1%). This may be because being overweight is a risk factor for hypertension.…”

“…19,20 Psychological stress may be influenced by both internal and external factors 9 , and there are many factors influencing psychological stress in hypertension; such as: illness perceptions, religiosity, perceived social support, physical activity, health literacy, hope, resilience, and coping behaviors. 10,21,22 As in the Common-Sense Model of Self-Regulation, psychological distress was one of the distinct categories of illness outcomes, and has been predicted by illness perceptions and coping strategies. 23 Previous studies reported illness perception as a predictor of psychological stress (R 2 =0.48, p-value<0.001).…”

Collection of selected articles 2019

“…Previous studies have proven the role of chronic stress in the formation and progression of arterial hypertension in particular and CVDs in general, directly potentiating systemic inflammation, as well as indirectly influencing behavioral changes. In a study by Lu X, et al (2019) shows that the association of stress with arterial hypertension changed by gender and ethnicity [14]. Asian-American men with high levels of stress were significantly more likely to develop arterial hypertension than men with low stress.…”