one more way our prison system is killing us

Jail Time Increases Odds of Hypertension, Researchers Find

By RONI CARYN RABIN

Published: April 13, 2009

Archives of Internal Medicine. 2009;169(7):687-693.

article abstract here 

Incarceration, Incident Hypertension, and Access to Health Care

Findings From the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Emily A. Wang, MD; Mark Pletcher, MD, MPH; Feng Lin, MS; Eric Vittinghoff, PhD, MPH; Stefan G. Kertesz, MD, MSc; Catarina I. Kiefe, MD, PhD; Kirsten Bibbins-Domingo, PhD, MD 

Background  Incarceration is associated with increased cardiovascular disease mortality, but prospective studies exploring mechanisms of this association are lacking.

Methods  We examined the independent association of prior incarceration with incident hypertension, diabetes, and dyslipidemia using the Coronary Artery Risk Development in Young Adults (CARDIA) study—a cohort of young adults aged 18 to 30 years at enrollment in 1985-1986, balanced by sex, race (black and white), and education (high school education or less). We also examined the association of incarceration with left ventricular hypertrophy on echocardiography and with barriers to health care access.

Results  Of 4350 participants, 288 (7%) reported previous incarceration. Incident hypertension in young adulthood was more common among former inmates than in those without incarceration history (12% vs 7%; odds ratio, 1.7 [95% confidence interval {CI}, 1.2-2.6]), and this association persisted after adjustment for smoking, alcohol and illicit drug use, and family income (adjusted odds ratio [AOR], 1.6 [95% CI, 1.0-2.6]). Incarceration was significantly associated with incident hypertension in those groups with the highest prevalence of prior incarceration, ie, black men (AOR, 1.9 [95% CI, 1.1-3.5]) and less-educated participants (AOR, 4.0 [95% CI, 1.0-17.3]). Former inmates were more likely to have left ventricular hypertrophy (AOR, 2.7, [95% CI, 0.9-7.9]) and to report no regular source for medical care (AOR, 2.5, [95% CI, 1.3-4.8]). Cholesterol levels and diabetes rates did not differ by history of incarceration.

Conclusions  Incarceration is associated with future hypertension and left ventricular hypertrophy among young adults. Identification and treatment of hypertension may be important in reducing cardiovascular disease risk among formerly incarcerated individuals.