Sharon B. Wyatt

University of Mississippi Medical Center | UMMC · School of Nursing

Background: Limited research has examined the association of life-course socioeconomic status (SES) with hypertension prevalence and incidence in a large cohort of African Americans. Methods: Among 4,761 participants from the Jackson Heart Study (JHS), we examined the association of SES indicators with prevalent and incident hypertension. We use...

Introduction: There are limited reports on the association of psychosocial factors with unhealthy behaviors, which are key mediators in the psychosocial-cardiovascular disease pathway. The Jackson Heart Study was used to examine the associations of multiple psychosocial factors with behaviors among African Americans. Methods: The Jackson Heart S...

Using data from Jackson Heart Study, we investigated the associations of neighborhood social and physical environments with prevalence and incidence of type 2 diabetes mellitus (T2DM) in African Americans (AA). Among non-diabetic participants at baseline (n=3670), 521 (14.2%) developed T2DM during a median follow-up of 7.3 years. Measures of neighb...

To our knowledge, no study has investigated the association of long-term exposure to traffic pollution with markers of atherosclerosis in 4 vascular beds simultaneously in an all-African-American cohort. Among participants in the Jackson Heart Study (Jackson, Mississippi; baseline mean age = 55.5 (standard deviation, 12.7) years), we used linear re...

Physical inactivity is an independent risk factor for many diseases. Most research has focused on individual-level factors for physical activity (PA), but evidence suggests that neighborhood is also important. We examined baseline data collected between 2000 and 2004 from 5236 participants in the Jackson Heart Study to determine the effects of neig...

BACKGROUND Research that examines the associations of psychosocial factors with incident hypertension among African Americans (AA) is limited. Using Jackson Heart Study (JHS) data, we examined associations of negative affect and stress with incident hypertension and blood pressure (BP) progression among AA. METHODS Our sample consisted of 1,656 no...

This review considers a variety of perspectives on overweight and obesity (OW/obesity), including measurement and classification; prevalence and changes in prevalence in recent years; genetic, biological, medical, individual, and social correlates of OW/obesity; and treatment approaches. Despite increased attention, OW/obesity is escalating in prev...

Background: Using Jackson Heart Study data, we examined associations of multiple measures of perceived discrimination with health behaviours among African-Americans (AA). Methods: The cross-sectional associations of everyday, lifetime and burden of discrimination with odds of smoking and mean differences in physical activity, dietary fat and sle...

Few studies have examined the impact of lifecourse socioeconomic position (SEP) on cardiovascular disease (CVD) risk among African Americans. We used data from the Jackson Heart Study (JHS) to examine the associations of multiple measures of lifecourse SEP with CVD events in a large cohort of African Americans. During a median of 7.2-year follow-up...

Background: African Americans (AA) have a higher risk of hypertension than other race/ethnic groups. Research that examines the associations of psychosocial factors with longitudinal changes in blood pressure (BP) and incident hypertension among AA is limited. Using Jackson Heart Study (JHS) data, we hypothesized that negative affect and stress are...

Blood pressure (BP) is a heritable risk factor for cardiovascular disease. To investigate genetic associations with systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP), we genotyped ∼50,000 SNPs in up to 87,736 individuals of European ancestry and combined these in a meta-analysis. We replicated findings in...

John Henryism connotes a strong behavioral predisposition to engage in effortful, active coping with difficult social and economic stressors. This behavioral predisposition is measured by the 12 item John Henryism Scale for Active Coping (JHAC). The John Henry hypothesis predicts that the well-known inverse socioeconomic status (SES)-blood pressure...

Hypertension treatment regimens used by African American adults in the Jackson Heart Study were evaluated at the first two clinical examinations (2415 treated hypertensive persons at examination I [exam I], 2000-2004; 2577 at examination II [exam II], 2005-2008). Blood pressure (BP) was below 140/90 mm Hg for 66% and 70% of treated participants at...

Though several large epidemiologic studies have demonstrated the positive association of anger with coronary heart disease (CHD) onset, a dearth of population-based evidence exists regarding the relationship of anger to the clinical course of CHD among people with established disease. Trait anger is conceptualized as a stable personality trait and...

Obesity continues to affect African Americans in epidemic proportions, particularly among women and adolescent females. Perceptions, beliefs, behaviors, and body sizes of adolescents are associated with those of their mothers, yet little is known about the transgenerational meanings and experiences of obese African American adolescent girls and the...

Blood pressure (BP) is a heritable determinant of risk for cardiovascular disease (CVD). To investigate genetic associations with systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP) and pulse pressure (PP), we genotyped ∼50 000 single-nucleotide polymorphisms (SNPs) that capture variation in ∼2100 candidate genes for cardiovascular...

Sleep-disordered breathing (SDB) is an increasingly recognized risk factor for cardiovascular disease (CVD). Limited data are available from large African American cohorts. We examined the prevalence, burden, and correlates of sleep symptoms suggestive of SDB and risk for obstructive sleep apnea (OSA) in the Jackson Heart Study (JHS), an all-Africa...

It is often hypothesized that psychosocial stress may contribute to associations of socioeconomic position (SEP) with risk factors for cardiovascular disease (CVD). However, few studies have investigated this hypothesis among African Americans, who may be more frequently exposed to stressors due to social and economic circumstances. Cross-sectional...

The impact of social support on health outcomes is well documented. The current study evaluated a short form of the Interpersonal Support Evaluation List (ISEL-SF) administered to 14,257 participants in the Atherosclerosis Risk in Communities study. Using confirmatory factor analysis, we attempted to replicate the subscale structure of the full-sca...

We examined the social patterning of cumulative dysregulation of multiple systems, or allostatic load, among African Americans adults. We examined the cross-sectional associations of socioeconomic status (SES) with summary indices of allostatic load and neuroendocrine, metabolic, autonomic, and immune function components in 4048 Jackson Heart Study...

This study investigated the number of pedometer assessment occasions required to establish habitual physical activity in African American adults. African American adults (mean age 59.9 ± 0.60 years; 59 % female) enrolled in the Diet and Physical Activity Substudy of the Jackson Heart Study wore Yamax pedometers during 3-day monitoring periods, asse...

There is evidence that anger and hostility are positively associated with the metabolic syndrome. In turn, the metabolic syndrome mediates the association between anger and hostility and adverse cardiac events. Very little is known about these associations in African-American populations. We assessed the hypothesis that anger and hostility are posi...

Using Jackson Heart Study data, we examined whether perceived discrimination was associated with prevalent hypertension in African Americans. Everyday discrimination, lifetime discrimination, burden of discrimination, and stress from discrimination were examined among 4939 participants aged 35 to 84 years (women = 3123; men = 1816). We estimated pr...

Subjective social status has been shown to be inversely associated with multiple cardiovascular risk factors, independent of objective social status. However, few studies have examined this association among African Americans and the results have been mixed. Additionally, the influence of discrimination on this relationship has not been explored. U...

There are several lines of evidence that suggest religiosity and spirituality are protective factors for both physical and mental health, but the association with obesity is less clear. This study examined the associations between dimensions of religiosity and spirituality (religious attendance, daily spirituality, and private prayer), health behav...

Manhattan plots for genome-wide association for A) eGFR; B) CKD; c) UACR; 4) MA. (TIF)

Regional association plots for all confirmed or replicating loci from the CKDGen loci interrogation; the blue notation represents the best SNP in whites with the p-value in African Americans, whereas red represents the lead SNP in African ancestry participants; the linkage disequilibrium shown uses YRI information from Hapmap2. (PDF)

Quantile-quantile plots for genome-wide association for A) eGFR; B) CKD; c) UACR; 4) MA. (TIF)

Cross-trait associations for novel loci from Stage 1+Stage 2 in participants of African ancestry. (DOC)

Diabetes and Hypertension stratified analyses, Stage 1 data. (DOC)

Regional association plot for the MYH9-APOL1 region in African ancestry participants. (TIF)

Genome-wide significant loci: SNP imputation quality* in Discovery and Replication cohorts. (DOC)

kcnq1 knockdown enhances loss of fluorescent dextran. Control and kcnq1 MO injected embryos were loaded with rhodamine-labeled dextran at 48 hpf. >80 embryos were analyzed for each group in 3 separate experiments (a,d) Fluorescence microscopy at 6 hpi reveals equal fluorescence loading between embryos. (b,e) At 72 hpf (24 hpi), fluorescence intensi...

Genotyping and imputation platforms. (DOC)

Analysis of glomerular architecture after kcnq1 knockdown by electron microscopy does not reveal significant changes. (a–c) Glomerular architecture at 120 hpf after injection of control morpholino visualized by electron microscopy at 8000-, 15,000, and 50,000-fold magnification reveals endothelial capillaries (C) with basement membrane (BM), podocy...

Dok6 and fndc1 knockdown in zebrafish embryos does not affect kidney development. (a–e) Uninjected control zebrafish embryos show normal glomerular and tubular morphology, as shown by in situ hybridization for the global kidney marker pax2a (a, inset showing lower-magnification image, with staining in both glomerulus and tubules), the podocyte mark...

Known loci for eGFRcrea and eGFRcys among participants of European Ancestry present on the IBC chip. (DOC)

Morpholino sequences. (DOC)

Study-specific methods. (DOC)

Chronic kidney disease (CKD) is an increasing global public health concern, particularly among populations of African ancestry. We performed an interrogation of known renal loci, genome-wide association (GWA), and IBC candidate-gene SNP association analyses in African Americans from the CARe Renal Consortium. In up to 8,110 participants, we perform...

Serum urate concentrations are highly heritable and elevated serum urate is a key risk factor for gout. Genome-wide association studies (GWAS) of serum urate in African American (AA) populations are lacking. We conducted a meta-analysis of GWAS of serum urate levels and gout among 5820 AA and a large candidate gene study among 6890 AA and 21 708 pa...

Little research has focused on the social patterning of diabetes among African Americans. We examined the relationship between socioeconomic status (SES) and the prevalence, awareness, treatment, and control of diabetes among African Americans. Education, income and occupation were examined among 4,303 participants (2,726 women and 1,577 men). Pois...

Blunted nocturnal blood pressure (NBP) dipping is a significant predictor of cardiovascular events. Lower socioeconomic position (SEP) may be an important predictor of NBP dipping, especially in African Americans (AA). However, the determinants of NBP dipping are not fully understood. The cross-sectional associations of individual and neighborhood...

We examined the associations of fast food restaurant (FFR) availability with dietary intake and weight among African Americans in the southeastern United States. We investigated cross-sectional associations of FFR availability with dietary intake and body mass index (BMI) and waist circumference in 4740 African American Jackson Heart Study particip...

African Americans have historically had high high-density lipoprotein cholesterol (HDL-C) compared with other races and ethnicities. We sought to characterize whether there is a cross-sectional association between age and HDL-C in a contemporary community-based study of African Americans. Cross-sectional data were modeled by logistic regression for...

The prevalence of hypertension in African Americans (AAs) is higher than in other US groups; yet, few have performed genome-wide association studies (GWASs) in AA. Among people of European descent, GWASs have identified genetic variants at 13 loci that are associated with blood pressure. It is unknown if these variants confer susceptibility in peop...

Admixture mapping based on recently admixed populations is a powerful method to detect disease variants with substantial allele frequency differences in ancestral populations. We performed admixture mapping analysis for systolic blood pressure (SBP) and diastolic blood pressure (DBP), followed by trait-marker association analysis, in 6303 unrelated...

To determine the effects of health insurance and race on prescription medication use and expense. An observational, non-experimental design was used. Multivariable regression analyses were conducted to evaluate the independent effects of health insurance status and race on prescription medication use and expense while controlling for sociodemograph...

Compared to whites, insulin-resistant African Americans have worse outcomes. Screening programs that could identify insulin resistance early enough for intervention to affect outcome often rely on triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) levels. Racial differences in TG and HDL-C may compromise the efficacy of these progra...

Background: Obesogenic environments, particularly the availability of inexpensive, energy-dense high-fat foods such as fast foods, are receiving increased attention as an ecological determinant of the obesity epidemic. However, there is limited empirical data on the relation of fast food restaurant (FFR) availability with dietary intake and weight...

The increasing use of geographic information systems (GIS) in epidemiological population studies requires careful attention to the methods employed in accomplishing geocoding and creating a GIS. Studies have provided limited details,hampering the ability to assess validity of spatial data. The purpose of this paper is to describe the multiphase geo...

Recent advances in geographic information systems software and multilevel methodology provide opportunities for more extensive characterization of "at-risk" populations in epidemiologic studies. The authors used age-restricted, geocoded data from the all-African-American Jackson Heart Study (JHS), 2000-2004, to demonstrate a novel use of the Lorenz...

To better understand how obesity and low levels of physical activity (PA) contribute to racial health disparities, we examined the association of PA domains (work, home life, and leisure) with indicators of socioeconomic status and markers of obesity in African Americans. These cross sectional analyses of interview and clinical measures from the ba...

Socioeconomic status (SES) is recognized as a key social environmental factor because it has implications for access to resources that help individuals care for themselves and others. Few studies have examined the association of SES with chronic kidney disease (CKD) in high-risk populations. Single-site longitudinal population-based cohort. Data fo...

Mistrust and fear of research often exist in minority communities because of assumptions, preconceived ideas, and historical abuse and racism that continue to influence research participation. The research establishment is full of well-meaning 'outsider' investigators who recognize discrimination, health disparities, and insufficient health care pr...

This study provided the first examination of the psychometric properties of the 6-item Daily Spiritual Experiences Scale (DSES) in a large African American sample, the Jackson Heart Study (JHS). The JHS included measures of spiritual (DSES) and religious practices. Internal reliability, dimensionality, fit indices, and correlation were assessed. DS...

To investigate the association of employment status with coronary heart disease (CHD) and ischemic stroke among middle-aged women. Proportional hazards regression was used to assess the association of employment status, incident CHD, and incident ischemic stroke among 7,058 women, ages 45-64 years at baseline (1987-1989), from the Atherosclerosis R...

Despite the high prevalence of cardiovascular disease documented among the African-American population, there has been little emphasis on the role of dyslipidemia as a prominent risk factor in this large subpopulation. Questions of medication efficacy also have been raised. Together, these factors may have affected awareness, diagnosis, and treatme...

Kidney disease is one of the most striking examples of health disparities in American public health. Disparities in the prevalence and progression of kidney disease are generally thought to be a function of group differences in the prevalence of kidney disease risk factors such as diabetes, hypertension, and obesity. However, the presence of these...

Chronic kidney disease (CKD) leads to end-stage renal disease and is a growing epidemic throughout the world. In the United States, African Americans have an incidence of end-stage renal disease 4 times that of whites. Cross-sectional to examine the prevalence and awareness of CKD in African Americans. Observational cohort in the Jackson Heart Stud...

Assessing the discrimination-health disparities hypothesis requires psychometrically sound, multidimensional measures of discrimination. Among the available discrimination measures, few are multidimensional and none have adequate psychometric testing in a large, African American sample. We report the development and psychometric testing of the mult...

Hypertension is a major cause of disease burden in all racial, ethnic, and socioeconomic groups in developing and developed regions and countries. Differences in blood pressure likely begin early in life and reflect a complex relationship of biologic, genetic, social, and environmental interactions. The relationship between socioeconomic status and...

African Americans have higher reported hypertension prevalence and lower control rates than other ethnic groups in the United States. Hypertension prevalence, awareness, treatment, and control (outcomes) and potentially associated demographic, lifestyle, comorbidity, and health care access factors were examined in 5249 adult participants (3362 wome...

The purpose of this study is to investigate the relationship between individual-level and neighborhood-level socioeconomic status (SES) across the life course and subclinical atherosclerosis. Participants from the Atherosclerosis Risk in Communities Study (n=12,332) were queried about individual-level SES and residential addresses across the life c...

This paper provides an overview of the evidence on the current epidemic of obesity in the United States. The prevalence of overweight and obesity now exceeds 60% among US adults, and the rate is rapidly increasing among children and adolescents. Dismal medical, social, and economic consequences are already apparent and likely to worsen without mult...

Despite the burgeoning research literature addressing spirituality and its measurements, few instruments have undergone rigorous reliability and validity testing. This study contributed to determining the reliability and validity of the 16- and 6-item Daily Spiritual Experiences Scale (DSES) in a convenience sample of African Americans ages 34-85....

Research on the risk of cardiovascular disease among individuals with prehypertension (blood pressure 120/80 to 139/89 mm Hg) is incomplete. Additional information among individuals with a high risk of cardiovascular disease complications may help to focus current and future efforts. We performed a prospective cohort analysis among 8960 middle-aged...

The design, overall methods, and major phenotypes for the all-African-American Jackson Heart Study (JHS) are detailed. Participants were enrolled from the three counties that make up the Jackson, Mississippi metropolitan area. Relatives of selected participants were recruited to develop a large, nested family cohort. Participants provided extensive...

The sampling and recruitment methods, response rate, and cohort description for the all-African-American Jackson Heart Study (JHS) are detailed. Four subsamples of participants residing in the Jackson, Mississippi metropolitan statistical area (MSA) were included: random, volunteer, ARIC (continuing from Atherosclerosis Risk in Communities study),...

This paper describes the preparation of genetic materials and the recruitment and initial characterization of a nested Family Study within the Jackson Heart Study (JHS) METHODS: Genomic DNA was prepared from all consenting JHS participants. In addition, family members of a subset of JHS participants were recruited to the JHS Family Study to allow h...

The Jackson Heart Study (JHS) is a prospective, population-based cohort study designed to investigate risk factors for cardiovascular disease (CVD) in African-American men and women. An aim of the JHS is the elucidation of the role that sociocultural factors play in the excess CVD risk and mortality in African Americans. Considerable evidence is av...