{"doi":"10.1093/ajh/hpad113","title":"Lower Socioeconomic Status, Psychological Distress, and Self-reported Hypertension: A Longitudinal Moderated Mediation Analysis","abstract":"BACKGROUND: Lower socioeconomic status (SES) has been associated with hypertension; however, the mediators and moderators of this association remain understudied. We examined the mediation effect of psychological distress on the link between lower SES and self-reported hypertension and the racial and sex moderation effects. METHODS: We analyzed the data collected from 2009 to 2019 among adults from the Panel Study of Income Dynamics (PSID). Lower SES was defined as one of 3 indicators: education ≤12 years, unemployed, or individual annual income <$27,800. Psychological distress was assessed using the Kessler K6 scale. Cox proportional hazard regression was conducted. Mediation analyses were performed using the PROCESS macro. RESULTS: In the sample of heads of family who did not have self-reported hypertension in 2009 (N = 6,214), the mean age was 41 years, 30.6% were female, 32.9% were African American. The cumulative incidence of self-reported hypertension was 29.8% between 2009 and 2019. Cox proportional hazard regression analysis showed that after controlling for covariates, lower SES (score > 0 vs. score = 0) was associated with self-reported hypertension (hazard ratio = 1.27, 95% confidence interval = 1.14-1.42). SES had indirect effect on self-reported hypertension through psychological distress and the indirect effect (0.02 in females, 0.01 in males, P < 0.05) was moderated by sex but not by race. CONCLUSIONS: The association of SES and self-reported hypertension was mediated by psychological distress and sex moderated the mediation effect. Interventions focused on reducing contributors to SES and psychological stress should be considered to reduce hypertension risk.","journal":"American Journal of Hypertension","year":2023,"id":350462,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":10,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.6103,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":446366,"name":"Rhonda Dailey","orcid":null,"position":1,"is_corresponding":false},{"id":267329,"name":"Robert D. Brook","orcid":"0000-0002-8521-7262","position":2,"is_corresponding":false},{"id":1073549,"name":"Ijeoma Nnodim Opara","orcid":"0000-0002-7231-9796","position":3,"is_corresponding":false},{"id":445600,"name":"Xianchen Liu","orcid":"0000-0003-0411-1050","position":4,"is_corresponding":false},{"id":1094417,"name":"Jason T. Carbone","orcid":"0000-0001-5096-5212","position":5,"is_corresponding":false},{"id":331877,"name":"Phillip D. Levy","orcid":"0000-0001-7306-5620","position":6,"is_corresponding":false},{"id":371956,"name":"Liying Zhang","orcid":"0000-0003-4815-9590","position":0,"is_corresponding":true}],"reference_count":29,"raw_metadata":null,"created_at":"2026-07-19T01:12:23.769679Z","pmid":"37991284","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}