Elizabeth L. Tung
CHICAGO — A surge in violent crime in 2015 was associated with rising BP in Chicago residents, with a larger increase observed for patients who lived in formerly low-crime areas compared with those who lived in high-crime areas, according to data presented at the American Heart Association Scientific Sessions.
“We found that as violent crime increased in a patient’s immediate neighborhood, we also saw increases in blood pressure, in missed outpatient appointments, and also in cardiovascular hospital admissions,” Elizabeth L. Tung, MD, MS, instructor of medicine in the section of general internal medicine at the University of Chicago, told Cardiology Today. “But when we zoomed out to the entire city, and compared typically low vs. high crime neighborhoods, we found that a neighborhood with lower crime in 2014 saw a slightly larger increase in blood pressure during the crime surge than a neighborhood with higher crime in 2014.”
To examine the immediate impact of rising crime on BP — and to see if this relationship is different between residents of low- and high-crime neighborhoods — researchers conducted a difference-in-differences analysis using health records of patients aged at least 18 years who were seen in outpatient clinics at an academic medical center in Chicago between May 2014 and August 2016 (n = 53,402 from 325 census tracts; 55% black; 64% women; mean age, 48 years).
Researchers compared changes in the odds of having elevated BP and absolute changes in systolic BP 1 year before and after the crime surge.
Each census tract was then classified as being a low-crime area (crime rate below median before the surge) or a high-crime area (crime rate above the median before the surge), and mixed-effects regression models were used to compare changes in BP between residents in each, adjusting for age, sex, race, insurance and month.
Researchers found that 22.5% of patients in census tracts with low crime and 36.5% of patients in census tracts with high crime had elevated BP.
A surge in violent crime in 2015 was associated with rising BP in Chicago residents, with a larger increase observed for patients who lived in formerly low-crime areas compared with those who lived in high-crime areas, according to data presented at the American Heart Association Scientific Sessions
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It was also observed that, for the low-crime census tracts, the crime surge was associated with an increase in the adjusted odds of having elevated BP (aOR = 1.09; 95% CI, 1.03-1.15) and an increase in absolute systolic BP (beta = 0.6 mm Hg; 95% CI, 0.4-0.9) compared with high-crime census tracts.
“Ultimately, our findings support the notion that there is a link between emotional health and heart health, and we can see impacts on the heart during these times of heightened fear and stress,” Tung said in an interview. “The Latin word for heart is ‘cor,' which is also the root for ‘courage.’ So, the notion that the heart is a reservoir for emotion goes back as far as language itself. We know that chronic stress and anxiety create what we call ‘allostatic load,’ which can impact heart health over time. Stress activates our ‘fight or flight’ response, which can cause our blood vessels to constrict and our heart rate to go up. Scientists think that chronic activation of this response over time can cause higher levels of activation at baseline or lower thresholds for activation (eg, from smaller triggers).” – by Melissa J. Webb
Tung EL, et al. Poster Sa1099. Presented at: American Heart Association Scientific Sessions; Nov. 10-12, 2018; Chicago.
Disclosures: The authors report no relevant financial disclosures.