An examination of the relationship between multiple dimensions of religiosity, blood pressure, and hypertension

Abstract

Researchers have established the role of heredity and lifestyle in the occurrence of hypertension, but the potential role of psychosocial factors, especially religiosity, is less understood. This paper analyzes the relationship between multiple dimensions of religiosity and systolic blood pressure, diastolic blood pressure, and hypertension using data taken from the Chicago Community Adult Health Study, a probability sample of adults (N = 3105) aged 18 and over living in the city of Chicago, USA. Of the primary religiosity variables examined here, attendance and public participation were not significantly related to the outcomes. Prayer was associated with an increased likelihood of hypertension, and spirituality was associated with increased diastolic blood pressure. The addition of several other religiosity variables to the models did not appear to affect these findings. However, variables for meaning and forgiveness were associated with lower diastolic blood pressure and a decreased likelihood of hypertension outcomes. These findings emphasize the importance of analyzing religiosity as a multidimensional phenomenon. This study should be regarded as a first step toward systematically analyzing a complex relationship.

Introduction

High blood pressure, or hypertension, is a well known risk factor for cardiovascular disease, heart attack, heart failure, stroke, and kidney disease (e.g., Chobanian et al., 2003). It is also becoming increasingly more common in the U.S. Twenty-two percent of adults 18 years of age and over have been told by a doctor on two or more visits that they have hypertension and this percentage increases dramatically with age (Pleis & Lethbridge-Cejku, 2006). The Framingham Heart Study showed that the lifetime risk for developing hypertension was 90% for men and women who were non-hypertensive at 55 or 65 years old and survived to 80 or 85 years old (Vasan et al., 2001). While researchers have established the role of heredity and lifestyle in the occurrence of hypertension, the potential role of psychosocial factors, especially religiosity, is less well understood.

The idea that a relationship exists between religiosity and hypertension is not new. One of the first studies to examine this relationship was published over forty years ago (Scotch, 1963), and a detailed review of the evidence first appeared nearly twenty years ago (Levin & Vanderpool, 1989). Since then, Koenig, McCullough, and Larson (2001) identified 16 studies of the relationship between religious involvement and blood pressure, 14 of which indicate that the more religious have lower blood pressure, especially lower diastolic blood pressure. Other researchers have concluded that there is “reasonable evidence” to suggest that religiosity is associated with lower blood pressure and less hypertension (Seeman, Dubin, & Seeman, 2003). At the same time, much of the existing work is limited by sampling design (e.g., age-restricted and non-representative samples), measurement (e.g., relying on single-item measures of religiosity such as service attendance or affiliation, or self-reports of hypertension), and a lack of adequate controls. Seeman et al. (2003), in particular, emphasize the need for a more precise specification and a more systematic examination of the multiple dimensions of religiosity that might differentially affect health outcomes (61).

We address some of these issues by analyzing the relationship between religiosity and systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension using data taken from the Chicago Community Adult Health Study, a probability sample of adults (N = 3105) aged 18 and over living in the city of Chicago, IL. These data are especially useful in that they permit us to examine multiple dimensions of religiosity including beliefs about attendance, religious coping, meaning, congregational support and criticism, and forgiveness.