Table 2.
Family Dynamics and Hypertension
| Author, Year |
Sample (n, age, age group, race, population, gender) |
Study Design |
Family variable | HT marker | Covariates | Results |
|---|---|---|---|---|---|---|
| Wang,Anderson [57] | N = 1,090 US children; 50.7% male; 12.1% AA 81.2% White,6.7% other | Longitudinal | Maternal depression when child was 1 month, age 2, and age 3 | BMI in grades one, three, and six | birth weight, gender, race, maternal education, SES, breastfed, parent smoker, maternal social support, maternal sensitivity | ↑ Maternal depressive symptoms at 1 month ↑BMI in 6th grade; BMI in 1st and 3rd grade ns. ↑ Maternal depression age 2 ↑ BMI in 3rd and 6th grade ↑ Maternal depression at age 3 ↑ BMI in 3rd grade Maternal depression at more time points ↑ BMI |
| Pretty, 2013 [47] | N = 1,234 Canadians adolescents;Mage =11.8;45% male | Cross sectional | Childhood adversity | Resting BP, HR, BMI, WC | family education, family income, parental history of hypertension, age, sex, physical activity | ≥4 adverse experiences ↑ HR; ↑ BMI; ↑ WC; BP ns. |
| Lumeng,2013 [56] | N = 848 US children; age 4 at baseline, 49.5% male; 82% White; 18% other | Longitudinal | Chronicity of negative events (i.e., negative life events at multiple time points); # of negative life events; impact of negative life events; timing of negative life events; parenting sensitivity | BMI at age 15 | gender, race/ethnicity, maternal education, maternal obesity | ↑ # of negative events ↑ BMI ↑ Chronicity of negative events = ↑ BMI Timing of negative life events BMI ns. Impact of negative life event BMI ns. ↑ Maternal parenting sensitivity ↓ BMI |
| Nikulina,2014 [46] | N = 806 US adults with documented childhood neglect and their matched control, Mage =41; 49% male;59% White, 35% AA, 6% other | Longitudinal | Documented childhood neglect | Resting BP,CRP, pulmonary functioning | gender, smoking, hypertension medication, asthma, BMI or other pulmonary disease diagnoses, neighborhood poverty, childhood family poverty |
Childhood neglect hypertension ns. In White participants, childhood neglect ↑ CRP; ↑ pulmonary functioning |
| Hernandez, 2014 [55] | N = 3,447 US adults; Mage =21.1; 54% male; 72% White; 19% AA, 9% Hispanic | Longitudinal | # of family structure changes throughout childhood (e.g. mother remarrying, mother divorcing) | BMI | Child: race, birth weight, depressive symptoms, self-esteem, # of siblings, duration since last family structure transition, age, year of BMI assessment; Mothers: age, relationship status, education status, change in education status, BMI | Main effects ns. In girls, ↑ family transitions ↑ BMI |
| Su, 2015 [48] | N = 394 US adults; age 5 at baseline; 47% male; 54.1% AA,45.9% White | Longitudinal | Childhood adversity | Resting BP via visits every 1 to 2 years over 23 years from childhood to adulthood | ethnicity, sex, BMI | Main effect = ns; Around age 30, ↑ACE ↑ SBP; ↑ DBP |
| Gupta-Malhotra.2016 [49] | N = 515 African American men; Mage = 47.8 | Retrospective | Lived with both parents from ages 1-12; lived with both parents from ages 13-19 | Resting BP,MAP, PP | age, material status, education, smoker, alcohol, physical activity, BMI, type 2 diabetes, obesity, family history of hypertension, current antihypertensive medication, HDL, LDL, triglycerides, sodium/potassium ratio |
Lived with both parents at any time between 1-12 ↑SBP; DBP ns. Lived with both parents at any time between 13-19 SBP ns.; DBP ns Lived with parents from 1-12 and 13-19 ↓ MAP; ↓PP |
| Boyer. 2015 [50] | N = 1,364 US children; pre-k at baseline; 52% male; 76% White, 24% persons of color | Longitudinal | Parental sensitivity at pre-k and 1st grade | BMI and resting BP at 6th and 9th grade | gender, ethnicity, family income-to-needs ratios | ↑ Both parent’s sensitivity ↓ BMI; ↓ SBP at 9th grade; SPB at 6th grade ns. |
| Gibson,2016 [54] | N = 286 community and clinical Australian population; Mage= 9.43; children; 49% male | Longitudinal | 1 parent vs 2 parents; parental laxness; over-reactivity; verbosity; psychological health/pathology of the family | BMI | Gender, age, SES, mother’s depression, mother’s stress, mother’s negative life, mother’s self-esteem, maternal obesity |
One parent home ↑ BMI Laxness, over-reactivity, verbosity, psychological health/pathology of the family BMI ns. In males, higher verbosity in parent ↑BMI |
| Chan. 2016[7] | N = 259 Canadian adolescents; ages 13-16; 47% male; 49.4% White,15.3% Asian | Cross sectional | Implicit affect; implicit warmth toward family; household crowding | Resting BP, total cholesterol, glycosylated hemoglobin, WC | age, gender, ethnicity | ↑ Early life crowding ↑SBP; DBP ns.; cholesterol ns.; HbA1c ns.; WC ns.; ↑ Implicit negative affect ↑ Total cholesterol; ↑SBP; ↑DBP; HbA1c ns.; WC ns. Implicit warmth SBP ns.; DBP ns.; HbA1c ns.; total cholesterol ns.; HbA1c ns.; WC ns. |
| Dong. 2017[51] | N = 940 Chinese parent-child pairs; ages 7–17, Mage =12.1; 56.17% male | Cross sectional | Resting BP,HbAlc, BMI from child and parent | age, sex, parental age, household structure, income, geographical region, parental education, urban/rural, parental smoking, caloric intake, physical activity | ↑ Parent's HbA1C
↑ child's HbA1c ↑Mother BP ↑ daughter's SBP; ↑daughter's DBP ↑Father CRP ↑child's CRP; ↑ son's obesity |
|
| Yavuz. 2018 [58] | N = 61 normal weight Turkish children and 61 overweight or obese Turkish children; Mage = 5.18 years old; 52.36% male | Cross sectional | Parenting style; food restriction; pressure to eat; food monitoring | Normal weight vs.obese/overweight | mother's education, parent's BMI, child's NA |
↑ authoritarian parenting ↑ obese/overweight Authoritative parenting BMI ns. ↑ Pressure to eat ↑ obese/overweight Food restriction BMI ns. Food monitoring BMI ns. |
| Heredia,2019 [59] | N= 1175 Mexican- American adolescents; ages 11-13 at baseline; 50% male | Longitudinal | Family cohesion; family conflict | BMI | Age, acculturation, household size, parent marital status, parent BMI, parent education, parent acculturation |
In females, ↑ family cohesion Decrease in BMI In females, ↑ family conflict Decrease in BMI |
Note. All results refer to child or adolescent’s cardiovascular outcomes. ns = not significant. AA = African American. BMI = body mass index. SES = social economic status. BP = blood pressure, WC = waist circumference. HR = heart rate. SBP = systolic blood pressure. DBP = diastolic blood pressure. HF = high-frequency bands. LF = low-frequency bands. CRP = C-Reactive protein. MAP = mean arterial pressure. PP = pulse pressure. HDL = high- density lipoprotein. FDF = low- density lipoprotein. HbAlc = hemoglobin Alc.