# An Intersectional Approach to Disparities in Hypertension Incidence and Progression

> **NIH NIH R21** · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · 2020 · $115,500

## Abstract

PROJECT SUMMARY/ ABSTRACT
Cardiovascular disease (CVD) is the leading cause of mortality among U.S. adults, and hypertension (HTN) is
the strongest risk factor for CVD. Under recently introduced guidelines, an estimated 46% of U.S. adults – or
103.3 million people – have HTN. HTN is not equally distributed through the population, and disease onset is
strongly predicted by race/ethnicity, socioeconomic position (SEP), and gender. Non-Hispanic blacks (NHB),
certain Hispanic sub-populations (e.g., middle-age/elderly, Puerto Ricans, Dominicans), and low SEP individuals
are at higher risk of HTN than non-Hispanic whites (NHW), in general. Additionally, the prevalence of HTN in
both Hispanic and NHB females is higher than that of their male counterparts; this is in contrast to NHW, among
whom differences in prevalence by sex vary by age. Although a number of factors have been identified as
possible contributors to HTN-related health disparities (including genetic and behavioral factors), these risk
factors do not fully explain HTN disparities, and social determinants of health have been suggested to explain
differential health outcomes despite shared genetic ancestry or similar health behaviors. Work is a critical
determinant of health, and a growing body of evidence suggests a positive relationship between work hour
patterns and HTN onset, particularly among work groups who may experience less desirable working conditions
and arrangements. However, little is known about the sociodemographic distribution of work hours (WH) or HTN-
related occupational risks. We will address these limitations by describing WH trajectories in a representative
sample of U.S. workers by race/ethnicity and gender (Aim 1) and assessing the effects of longitudinal, time-
varying WH trajectories on incident HTN by race/ethnicity and gender (Aim 2). Next, we will estimate the influence
of WH and race/ethnicity on HTN-related health decline by gender (Aim 3). These aims will be executed in a
data set constructed by merging a nationally representative panel study (Panel Study of Income Dynamics, or
PSID) with job-characteristics data sponsored by the U.S. Department of Labor (U.S. Occupational Information
Network, or O*NET) across 30 years to yield one of the most comprehensive data sets to date for the examination
of work-related factors on HTN incidence and HTN-related health decline. The proposed project supports the
National Heart, Lung and Blood Institute’s focus on investigating factors that account for differences in health
among populations. Findings from this cost-effective, innovative study will broaden our scientific understanding
of the influence of WH on HTN incidence and related health decline in vulnerable populations and could have
substantial Research to Practice (r2p) implications across multiple programmatic and policy arenas, including
healthcare, education, and workplace wellness. Workplace practices, including long WH, can be addressed (at
least partially) t...

## Key facts

- **NIH application ID:** 9989892
- **Project number:** 5R21HL145487-02
- **Recipient organization:** UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
- **Principal Investigator:** Ruosha Li
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $115,500
- **Award type:** 5
- **Project period:** 2019-08-15 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9989892

## Citation

> US National Institutes of Health, RePORTER application 9989892, An Intersectional Approach to Disparities in Hypertension Incidence and Progression (5R21HL145487-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9989892. Licensed CC0.

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