{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T09:49:41Z","timestamp":1791539381795,"version":"4.3.4"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Population Health and Outcomes"],"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Hypertension is the leading risk factor for cardiovascular disease, with disparities observed by race. Few studies have examined how intersecting social and sex-based biological determinants influence hypertension incidence among parous individuals and across racial groups. The objective of this study was to examine whether female-specific cardiovascular disease risk factors (eg, adverse pregnancy outcomes), individual-level (eg, education), and structural-level (eg, neighborhood) social drivers of health (SDoH), beyond traditional cardiovascular disease risk factors (eg, physical activity), explain the Black-White disparity in hypertension following pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Parous individuals in CARDIA (Coronary Artery Risk Development in Young Adults), a longitudinal cohort study beginning in 1985 to 1986, without hypertension before their first pregnancy were included. Race was self-reported at enrollment. Blood pressure was measured at each examination, with hypertension incidence defined as the first elevated blood pressure (systolic \u2265130 mm\u2009Hg or diastolic \u226580 mm\u2009Hg) or initiation of antihypertensive medication after baseline. Participant follow-up time began at the next exam following their first live delivery. Cox proportional hazards models with time-varying covariates calculated hazard ratios and 95% CIs. To quantify how much each set of covariates explained the Black-White difference in hypertension risk, the percentage reduction in the race coefficient was calculated following the addition of female-specific cardiovascular disease risk factors and SDoH in multivariable-adjusted regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Among 1653 participants (29.4\u00b16.1 years), Black women (n=924) had higher hypertension incidence than White women (n=729): 41.4 versus 18.5 per 1000 person-years, respectively; and an earlier median age at onset (42 versus 48 years). Following traditional risk factors, individual-level SDoH explained the largest disparity (7.52%), followed by female-specific factors (2.26%) and structural-level SDoH (1.50%). Black women remained at higher risk after adjustment (hazard ratio, 2.72 [95% CI, 2.17\u20133.41]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Parous Black women face substantially higher hypertension rates than White women, persisting after accounting for traditional risk factors, female-specific risk factors, and SDoH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circoutcomes.126.013605","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T09:00:49Z","timestamp":1791536449000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Drivers of Black-White Disparities in Hypertension Risk After Pregnancy: Findings From CARDIA"],"prefix":"10.1161","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3351-0173","authenticated-orcid":true,"given":"Jaclyn D.","family":"Borrowman","sequence":"first","affiliation":[{"name":"Tualne University, New Orleans, LA (J.D.B., E.W.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4629-5847","authenticated-orcid":true,"given":"Xuan","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9620-1402","authenticated-orcid":true,"given":"Abbi D.","family":"Lane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0319-0922","authenticated-orcid":true,"given":"Emily W.","family":"Harville","sequence":"additional","affiliation":[{"name":"Tualne University, New Orleans, LA (J.D.B., E.W.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0063-6397","authenticated-orcid":true,"given":"Kiarri","family":"Kershaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7035-0848","authenticated-orcid":true,"given":"Mercedes R.","family":"Carnethon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2020.100297"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.122.19275"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.110.160341"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301395"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.007988"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-022-01826-x"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.036748"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/CRD.0000000000000253"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.121.17104"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2015.5653"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2010.2291"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1669441"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xagr.2025.100519"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-023-02319-x"},{"key":"e_1_3_3_16_2","volume-title":"Advancing research on chronic conditions in women","author":"National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on a Framework for the Consideration of Chronic Debilitating Conditions in Women","year":"2024","unstructured":"National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on a Framework for the Consideration of Chronic Debilitating Conditions in Women. Advancing research on chronic conditions in women. National Academies Press (US); 2024. Accessed November 3, 2025. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK604853\/"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(88)90080-7"},{"key":"e_1_3_3_18_2","volume-title":"Rethinking race and ethnicity in biomedical research","unstructured":"Rethinking race and ethnicity in biomedical research. Accessed June 8, 2026. https:\/\/www.nationalacademies.org\/projects\/HMD-HSP-22-14\/publication\/27913"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1891\/1061-3749.22.3.511"},{"key":"e_1_3_3_20_2","volume-title":"Social determinants of health","unstructured":"Social determinants of health. Accessed October 16, 2024. https:\/\/www.who.int\/health-topics\/social-determinants-of-health"},{"key":"e_1_3_3_21_2","volume-title":"Social determinants of health. public health professionals gateway","author":"CDC","unstructured":"CDC. Social determinants of health. public health professionals gateway. May 14, 2024. 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