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ASTHMA, ENVIRONMENTAL RISK FACTORS, AND HYPERTENSION AMONG ARAB AMERICANS IN THE METRO DETROIT AREA
Citation:
JOHNSON, M. M., J. O. NRIAGU, A. HAMMAD, K. SAVOIE, AND H. JAMIL. ASTHMA, ENVIRONMENTAL RISK FACTORS, AND HYPERTENSION AMONG ARAB AMERICANS IN THE METRO DETROIT AREA. Presented at 4th National Conference on Health Issues in the Arab American Community, Dearborn, MI, May 11 - 12, 2006.
Description:
The importance of environmental risk factors in asthma etiology has been well-documented, and certain environmental risk factors have also been associated with hypertension. However, few previous studies have examined the relationship between hypertension and asthma. This study explores the relationships between hypertension, asthma and environmental risk factors in a population of 600 Arab American adults in the Metro Detroit area. We used an Environmental Risk Index (ERI) to quantify household environmental risk factors associated with asthma; physician diagnosed hypertension was self-reported. Asthma status was determined using responses to a validated symptoms checklist and self-reported diagnosis by a physician. Hypertension was significantly associated with asthma after adjusting for age, gender, health care access, socio-economic status (SES), and marital status. The prevalence of asthma and hypertension was not significantly different among men and women in the study population. Comparing the relationship between environmental risk factors and asthma, we found that ERI was significantly associated with asthma among participants with and without hypertension; however, the relationship between environmental risk factors and asthma was stronger among participants with hypertension. This interaction was stronger among women in the study population, and was statistically significant adjusting for age, health care access, SES, and marital status. These results are consistent with the disproportionate asthma risk associated with obesity among women. Specific risk factors implicated in this relationship will be discussed. We also considered the impact of other potentially mediating factors such as age and time spent at home. Age was positively associated with asthma and hypertension in the study population; however the relationship between ERI, hypertension and asthma did not vary significantly by age. Using full-time employment as a surrogate for time spent outside the home, we found that the relationship between ERI, asthma, and hypertension was stronger among study participants who spent more time at home. This effect modification was statistically significant controlling for age, health care access, SES, and marital status. Our results suggest that hypertension may impact asthma not only through shared risk factors, but through an increased vulnerability to environmental stressors. These findings also suggest that household risk factors may have a stronger adverse effect among individuals who spend more time at home, possibly due to prolonged duration of exposure or a greater degree of vulnerability among those individuals.