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Article ; Online: Mental health and neurocognitive disorder-related hospitalization rates in immigrants and Canadian-born population: a linkage study.

Grundy, Anne / Ng, Edward / Rank, Claudia / Quinlan, Jacklyn / Giovinazzo, George / Viau, Rachel / Ponka, David / Garner, Rochelle

Canadian journal of public health = Revue canadienne de sante publique

2023 Volume 114, Issue 4, Page(s) 692–704

Abstract: Objectives: Mental health and neurocognitive conditions are important causes of hospitalization among immigrants, though patterns may vary by immigrant category, world region of origin, and time since arrival in Canada. This study uses linked ... ...

Abstract	Objectives: Mental health and neurocognitive conditions are important causes of hospitalization among immigrants, though patterns may vary by immigrant category, world region of origin, and time since arrival in Canada. This study uses linked administrative data to explore differences in mental health hospitalization rates between immigrants and individuals born in Canada. Methods: Hospital records from the Discharge Abstract Database and the Ontario Mental Health Reporting System for 2011 to 2017 were linked to the 2016 Longitudinal Immigrant Database and to Statistics Canada's 2011 Canadian Census Health and Environment Cohort. Age-standardized hospitalization rates for mental health-related conditions (ASHR-MHs) were derived for immigrants and the Canadian-born population. ASHR-MHs overall and for leading mental health conditions were compared between immigrants and the Canadian-born population, stratified by sex and selected immigration characteristics. Quebec hospitalization data were not available. Results: Overall, immigrants had lower ASHR-MHs compared to the Canadian-born population. Mood disorders were leading causes of mental health hospitalization for both cohorts. Psychotic, substance-related, and neurocognitive disorders were also leading causes of mental health hospitalization, although there was variation in their relative importance between subgroups. Among immigrants, ASHR-MHs were higher among refugees and lower among economic immigrants, those from East Asia, and those who arrived in Canada most recently. Conclusion: Differences in hospitalization rates among immigrants from various immigration streams and world regions, particularly for specific types of mental health conditions, highlight the importance of future research that incorporates both inpatient and outpatient mental health services to further understand these relationships.
MeSH term(s)	Humans ; Canada/epidemiology ; Mental Health ; Emigrants and Immigrants ; Hospitalization ; Ontario/epidemiology ; Neurocognitive Disorders
Language	English
Publishing date	2023-02-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	417262-0
ISSN	1920-7476 ; 0008-4263
ISSN (online)	1920-7476
ISSN	0008-4263
DOI	10.17269/s41997-023-00740-1
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Article ; Online: Hospitalization related to chronic hepatitis B and C in recent immigrants in Canada: An immigration administrative data-linked, population-based cohort study.

Ng, Edward / Quinlan, Jacklyn / Giovinazzo, George / Syoufi, Maria / Massenat, Dominique Elien / Sanmartin, Claudia / Cooper, Curtis

Health reports

2022 Volume 33, Issue 6, Page(s) 30–45

Abstract: Background: Canadian immigrants from countries where the hepatitis B virus (HBV) and hepatitis C virus (HCV) are endemic may be at higher risk of liver-related disease than Canadian-born residents. This study compared HBV- and HCV-related ... ...

Abstract	Background: Canadian immigrants from countries where the hepatitis B virus (HBV) and hepatitis C virus (HCV) are endemic may be at higher risk of liver-related disease than Canadian-born residents. This study compared HBV- and HCV-related hospitalizations in Canadian immigrants (arriving from 1980 to 2013) and long-term residents (Canadian-born population and pre-1980 immigrants) and aimed to describe the burden of disease in both groups. Methods: Based on the 2004/2005-to-2013/2014 hospital Discharge Abstract Database linked to the 1980-to-2013 Longitudinal Immigration Database, this descriptive cross-sectional study examined the distribution of HBV- and HCV-related hospitalizations, lengths of stay, comorbidities, and sequelae incurred by immigrants and long-term residents in Canada. With a linkage rate of 85%, 5,854,949 immigrants were included in the study. Proportions of HBV- and HCV-related hospitalizations attributable to immigrants were calculated. Results: By birth country risk level, 22% of HBV-related hospital events among recent immigrants, and 20% of those related to HCV, were among people from high-risk countries. Proportionally, fewer immigrants had comorbidities than long-term residents. The top two hospital-related sequelae in both groups were cirrhosis and ascites, and liver cancer. While immigrants made up 16% of the Canadian population, they incurred 37% of HBV-related hospitalizations and 9% of HCV-related hospitalizations, giving ratios of hepatitis-related hospitalizations relative to the population share of 2.3 (95% confidence interval [CI]: 2.2 to 2.5) and 0.5 (95% CI: 0.5 to 0.6) respectively. These ratios were higher among seniors, at 4.4 (95% CI: 3.9 to 4.9) and 2.3 (95% CI: 1.9 to 2.6), respectively. Interpretation: Immigrants can require hospitalization for hepatitis in Canada, especially for HBV. These results may inform health screening for HBV or HCV in the Canadian immigration context.
MeSH term(s)	Canada/epidemiology ; Cohort Studies ; Cross-Sectional Studies ; Emigrants and Immigrants ; Emigration and Immigration ; Hepatitis B/epidemiology ; Hepatitis B, Chronic/epidemiology ; Hepatitis C/epidemiology ; Hospitalization ; Humans
Language	English
Publishing date	2022-07-25
Publishing country	Canada
Document type	Journal Article
ZDB-ID	1057245-4
ISSN	1209-1367 ; 0840-6529
ISSN (online)	1209-1367
ISSN	0840-6529
DOI	10.25318/82-003-x202200600003-eng
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Article ; Online: Congenital Malaria in Newborns Presented at Tororo General Hospital in Uganda: A Cross-Sectional Study.

Hangi, Mumbere / Achan, Jane / Saruti, Aimé / Quinlan, Jacklyn / Idro, Richard

The American journal of tropical medicine and hygiene

2019 Volume 100, Issue 5, Page(s) 1158–1163

Abstract: Despite recent large-scale investments, malaria remains a major public health concern. Few studies have examined congenital malaria, defined as the presence of malaria parasitemia within the first 7 days of life, in endemic areas. This study aimed to ... ...

Abstract	Despite recent large-scale investments, malaria remains a major public health concern. Few studies have examined congenital malaria, defined as the presence of malaria parasitemia within the first 7 days of life, in endemic areas. This study aimed to determine the prevalence, to describe the clinical presentation, and to examine factors associated with congenital malaria in newborns aged up to 7 days attending Tororo General Hospital in Uganda. A total of 261 mother/baby pairs were recruited in this cross-sectional study. Giemsa-stained thick blood smears for malaria parasites and rapid malaria diagnostic tests were performed on capillary blood samples from all newborns and mothers, as well as on placental and cord samples from newborns delivered in the hospital. The prevalence of congenital malaria in the newborns was 16/261 (6.1%). No single clinical feature was associated with congenital malaria. However, there were associations between congenital malaria and maternal parasitemia (
MeSH term(s)	Adolescent ; Cross-Sectional Studies ; Female ; Fetal Blood/parasitology ; Hospitals, General ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases/epidemiology ; Infant, Newborn, Diseases/parasitology ; Malaria/blood ; Malaria/congenital ; Malaria/epidemiology ; Maternal Age ; Mothers/statistics & numerical data ; Parasitemia/congenital ; Parasitemia/epidemiology ; Placenta/parasitology ; Pregnancy ; Pregnancy Complications, Parasitic/epidemiology ; Pregnancy Complications, Parasitic/prevention & control ; Prevalence ; Uganda ; Young Adult
Language	English
Publishing date	2019-03-11
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2942-7
ISSN	1476-1645 ; 0002-9637
ISSN (online)	1476-1645
ISSN	0002-9637
DOI	10.4269/ajtmh.17-0341
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Article ; Online: Prevalence, short term outcome and factors associated with survival in patients suffering from upper gastrointestinal bleeding in a resource limited-setting, the case of Mulago hospital in Kampala, Uganda.

Kiringa, Serge Kahatwa / Quinlan, Jacklyn / Ocama, Ponciano / Mutyaba, Innocent / Kagimu, Magid

African health sciences

2020 Volume 20, Issue 1, Page(s) 426–436

Abstract: Background: Upper gastrointestinal bleeding (UGIB) is a common cause of admission and death in the gastroenterology service. The prevalence, risk factors and the case fatality rate of UGIB may differ by settings.: Objectives: Our objective was to ... ...

Abstract	Background: Upper gastrointestinal bleeding (UGIB) is a common cause of admission and death in the gastroenterology service. The prevalence, risk factors and the case fatality rate of UGIB may differ by settings. Objectives: Our objective was to determine the prevalence of symptoms and the case fatality rate of UGIB among patients at the gastroenterology service of Mulago Hospital in Kampala, Uganda and to describe the clinical and laboratory risk factors associated with the survival of these patients. Methods: In a cross-sectional study performed between September 2013 and April 2014, patients were screened for UGIB symptoms. Data was collected on socio-demographic characteristics, clinical presentation and patient's outcome within one week of admission. Bivariate, multivariate, and survival analysis were performed to identify variables that were significantly associated with mortality. Results: Out of 1085 patients screened, we identified the prevalence of UGIB symptoms in 220 patients (20.3%). Among these, 150 met the inclusion criteria for our study. The majority were males (70.7%) and 40 years of age or less (60%). The most prevalent clinical diagnosis were gastritis (39.3%), esophageal varices (17.3%) and peptic ulcer disease (PUD) (16%). Among patients who underwent endoscopy, esophageal varices (42.2%), PUD (26.3%) and gastritis (15.8%) were the leading causes of bleeding. The overall case fatality rate was 16.7% (25/150). Uremia remained associated with mortality after controlling for confounders.Survival was significantly reduced for males as well as for patients with uremia and malignancy. Conclusion: the prevalence of symptoms and the case fatality rate of UGIB among patients admitted to the gastroenterology ward in Mulago hospital were higher than in developed countries and similar to other resource-limited setting. The majority of patients were young men and presented with both hematemesis and melena. The most common causes of UGIB were esophageal varices, gastritis and PUD. Survival analysis indicate that male gender, uremia, and malignancy are associated with reduced survival.
MeSH term(s)	Adult ; Aged ; Cross-Sectional Studies ; Endoscopy/adverse effects ; Endoscopy/methods ; Endoscopy, Gastrointestinal/adverse effects ; Endoscopy, Gastrointestinal/methods ; Esophageal and Gastric Varices/complications ; Esophageal and Gastric Varices/epidemiology ; Female ; Gastritis/complications ; Gastritis/epidemiology ; Gastrointestinal Hemorrhage/diagnosis ; Gastrointestinal Hemorrhage/epidemiology ; Gastrointestinal Hemorrhage/etiology ; Hospitalization/statistics & numerical data ; Humans ; Male ; Middle Aged ; Peptic Ulcer/complications ; Peptic Ulcer/epidemiology ; Prevalence ; Risk Factors ; Sex Factors ; Socioeconomic Factors ; Uganda/epidemiology
Language	English
Publishing date	2020-12-29
Publishing country	Uganda
Document type	Journal Article
ZDB-ID	2240308-5
ISSN	1729-0503 ; 1680-6905
ISSN (online)	1729-0503
ISSN	1680-6905
DOI	10.4314/ahs.v20i1.49
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Zs.A 3851: Show issues

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Article ; Online: All-cause acute care hospitalization rates of immigrants and the Canadian-born population: A linkage study.

Ng, Edward / Quinlan, Jacklyn / Giovinazzo, George / Grundy, Anne / Rank, Claudia / Syoufi, Maria / Ponka, David / Garner, Rochelle

Health reports

2021 Volume 32, Issue 9, Page(s) 3–13

Abstract: Background: As Canadian immigration levels increase, knowledge concerning immigrant health becomes increasingly important for health system policy and planning. This study compares the rate of all-cause hospitalization among immigrants with that of ... ...

Abstract	Background: As Canadian immigration levels increase, knowledge concerning immigrant health becomes increasingly important for health system policy and planning. This study compares the rate of all-cause hospitalization among immigrants with that of their Canadian-born counterparts. Data and methods: Using records from the Discharge Abstract Database (2004/2005 to 2016/2017) and the Ontario Mental Health Reporting System (2006/2007 to 2017/2018) linked to the 2016 Longitudinal Immigration Database, this study compared the age-standardized hospitalization rates (ASHRs) among immigrants with those of the Canadian-born population; the latter were obtained from a linkage based on the 2011 National Household Survey. Comparisons were made at the International Classification of Diseases chapter level by immigrant landing year, admission category and world region of birth. Quebec data were not available. Results: Overall, ASHRs among immigrants were lower than for the Canadian-born population. Immigrants in the economic class had the lowest ASHR, followed by those in the family class and among refugees. After pregnancy was excluded, leading hospitalization causes were similar for immigrants and the Canadian-born population, where top causes included digestive system and circulatory diseases, injuries, and cancer. In male and female immigrants, the ASHRs were lowest among those from East Asia. By landing year, males arriving earlier had the highest ASHR compared with the most recent arrivals. When pregnancy was excluded and while the differential in ASHRs among females by landing year remained, the magnitude was smaller. Interpretation: These results corroborate those from previous studies suggesting a healthy immigrant effect, but also reveal heterogeneity in ASHRs within the immigrant population. They provide a baseline for comparison of health status between populations, which enables further monitoring and informs health-system policy and planning.
MeSH term(s)	Emigrants and Immigrants ; Emigration and Immigration ; Female ; Hospitalization ; Humans ; Male ; Ontario ; Refugees
Language	English
Publishing date	2021-09-23
Publishing country	Canada
Document type	Journal Article
ZDB-ID	1057245-4
ISSN	1209-1367 ; 0840-6529
ISSN (online)	1209-1367
ISSN	0840-6529
DOI	10.25318/82-003-x202100900001-eng
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Article ; Online: Association of MAOA genetic variants and resilience with psychosocial stress: A longitudinal study of Syrian refugees.

Clukay, Christopher J / Dajani, Rana / Hadfield, Kristin / Quinlan, Jacklyn / Panter-Brick, Catherine / Mulligan, Connie J

PloS one

2019 Volume 14, Issue 7, Page(s) e0219385

Abstract: Early childhood trauma can have profound and lifelong effects on adult mental health and psychosocial wellbeing. Nevertheless, responses to trauma are highly variable. Genetic variants may help explain variation in responses to trauma by identifying ... ...

Abstract	Early childhood trauma can have profound and lifelong effects on adult mental health and psychosocial wellbeing. Nevertheless, responses to trauma are highly variable. Genetic variants may help explain variation in responses to trauma by identifying alleles that associate with changes in mental health measures. Protective factors, such as resilience, likely also play an important role in responses to trauma. The effects of genetic variants, in combination with protective factors, on psychosocial health are not well understood, particularly in non-Western contexts. In this study, we test the relative influence of genetic variants of monoamine oxidase A (MAOA, a gene proposed to influence the impact of childhood trauma on adult violence and antisocial behavior), levels of resilience, and exposure to traumatic events on psychosocial stress and mental health trajectories over time. We use data from a cohort of 12-18-year-old Syrian refugees who were forcibly displaced to neighboring Jordan (n = 399). DNA samples and survey data on trauma exposure, resilience (CYRM-12), and psychosocial stress were collected at three time points: baseline, ~13 weeks, and ~48 weeks. Using multilevel models, we identified an association of MAOA variant, in males only, with symptom scores of psychosocial stress on the Perceived Stress Scale (PSS) over time (p = 8.1 x 10-4). We also found that resilience is strongly associated with PSS (p = 7.9 x 10-9), underscoring the importance of protective factors in influencing levels of psychosocial stress. Furthermore, there was an additive effect wherein the sharpest reductions in perceived psychosocial stress are seen in low-activity MAOA males with low trauma exposure or high resilience levels. Our results highlight the value of studies that integrate genetic and psychosocial factors to better understand complex phenotypes, such as responses to trauma in contexts of high trauma exposure.
MeSH term(s)	Adolescent ; Adverse Childhood Experiences ; Armed Conflicts ; Child ; Female ; Genetic Variation ; Humans ; Jordan ; Male ; Monoamine Oxidase/genetics ; Phenotype ; Protective Factors ; Psychiatric Status Rating Scales ; Psychological Trauma ; Refugees/psychology ; Resilience, Psychological ; Stress, Psychological ; Syria/epidemiology ; Violence
Chemical Substances	Monoamine Oxidase (EC 1.4.3.4) ; monoamine oxidase A, human (EC 1.4.3.4.)
Language	English
Publishing date	2019-07-17
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0219385
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Article ; Online: Association of MAOA genetic variants and resilience with psychosocial stress

Christopher J Clukay / Rana Dajani / Kristin Hadfield / Jacklyn Quinlan / Catherine Panter-Brick / Connie J Mulligan

PLoS ONE, Vol 14, Iss 7, p e

A longitudinal study of Syrian refugees.

2019 Volume 0219385

Abstract	Early childhood trauma can have profound and lifelong effects on adult mental health and psychosocial wellbeing. Nevertheless, responses to trauma are highly variable. Genetic variants may help explain variation in responses to trauma by identifying alleles that associate with changes in mental health measures. Protective factors, such as resilience, likely also play an important role in responses to trauma. The effects of genetic variants, in combination with protective factors, on psychosocial health are not well understood, particularly in non-Western contexts. In this study, we test the relative influence of genetic variants of monoamine oxidase A (MAOA, a gene proposed to influence the impact of childhood trauma on adult violence and antisocial behavior), levels of resilience, and exposure to traumatic events on psychosocial stress and mental health trajectories over time. We use data from a cohort of 12-18-year-old Syrian refugees who were forcibly displaced to neighboring Jordan (n = 399). DNA samples and survey data on trauma exposure, resilience (CYRM-12), and psychosocial stress were collected at three time points: baseline, ~13 weeks, and ~48 weeks. Using multilevel models, we identified an association of MAOA variant, in males only, with symptom scores of psychosocial stress on the Perceived Stress Scale (PSS) over time (p = 8.1 x 10-4). We also found that resilience is strongly associated with PSS (p = 7.9 x 10-9), underscoring the importance of protective factors in influencing levels of psychosocial stress. Furthermore, there was an additive effect wherein the sharpest reductions in perceived psychosocial stress are seen in low-activity MAOA males with low trauma exposure or high resilience levels. Our results highlight the value of studies that integrate genetic and psychosocial factors to better understand complex phenotypes, such as responses to trauma in contexts of high trauma exposure.
Keywords	Medicine ; R ; Science ; Q
Subject code	150
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
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Article ; Online: Systematic review of the association between chronic social stress and telomere length: A life course perspective.

Oliveira, Bruna Silva / Zunzunegui, Maria Victoria / Quinlan, Jacklyn / Fahmi, Hassan / Tu, Mai Thanh / Guerra, Ricardo Oliveira

Ageing research reviews

2016 Volume 26, Page(s) 37–52

Abstract: Our aim was to examine whether chronic social stress is associated with telomere length throughout the life course, following our protocol published in 2014. Structured searches were conducted in MEDLINE (PubMed interface), EMBASE (OVID interface), ... ...

Abstract	Our aim was to examine whether chronic social stress is associated with telomere length throughout the life course, following our protocol published in 2014. Structured searches were conducted in MEDLINE (PubMed interface), EMBASE (OVID interface), Cochrane Central (OVID interface) and grey from their start date onwards. Reference lists of retrieved citations were hand searched for relevant studies. Eighteen studies published until May 1, 2015 investigating the association between chronic social stress (as defined by poverty, exposure to violence, or family caregiving) and telomere length in healthy or diseased adults and children were independently selected by 2 reviewers. Sixteen of those studies were cross-sectional and two had a longitudinal design. Studies differed in type of stress exposure, method to measure telomere length and cell type. As meta-analysis could not be conducted, the data were synthesized as a narrative review. Based on this comprehensive review, chronic social stress accompanies telomere shortening in both early and adult exposures, with most eligible studies showing a significant relationship. We discuss the significance of chronic stress of social origin and the potential for social interventions through public policies and we recommend methodological improvements that would allow for future meta-analysis.
MeSH term(s)	Adult ; Child ; Family Health ; Humans ; Poverty/psychology ; Social Environment ; Social Support ; Stress, Psychological/etiology ; Stress, Psychological/physiopathology ; Telomere Homeostasis/physiology ; Telomere Shortening ; Violence/psychology
Language	English
Publishing date	2016-03
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2075672-0
ISSN	1872-9649 ; 1568-1637
ISSN (online)	1872-9649
ISSN	1568-1637
DOI	10.1016/j.arr.2015.12.006
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Zs.A 5579: Show issues

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Article ; Online: Lifecourse Adversity and Telomere Length in Older Women from Northeast Brazil.

Oliveira, Bruna Silva / Zunzunegui, Maria Victoria / Quinlan, Jacklyn / Batistuzzo de Medeiros, Silvia Regina / Thomasini, Ronaldo Luis / Guerra, Ricardo Oliveira

Rejuvenation research

2017 Volume 21, Issue 4, Page(s) 294–303

Abstract: We examined associations between adverse childhood experiences (ACEs) and shorter telomere length (TL) in 83 older women, including 42 women with less than secondary education and 41 with secondary or more education in a city of Northeast Brazil, a ... ...

Abstract	We examined associations between adverse childhood experiences (ACEs) and shorter telomere length (TL) in 83 older women, including 42 women with less than secondary education and 41 with secondary or more education in a city of Northeast Brazil, a region with substantial socioeconomic inequalities. The low education sample was selected from a representative survey at local neighborhood health centers, while the high education group consisted of a convenience sample recruited by advertising in community centers and centers affiliated with the local university. Relative leukocyte TL was measured by quantitative polymerase chain reaction from blood samples. ACEs were self-reported. Spline linear regression was fitted to assess the strength of the associations between ACEs and TL. Among women with low education, median TL was 1.02 compared with 0.64 in the high education group (p = 0.0001). Natural log-transformed T/S ratio as the dependent variable was used in analysis. Women with low education had been exposed to more ACEs, and among them those experiencing two or more ACEs had longer TL than women exposed to ≤1 ACEs (p = 0.03); among women with high education, this difference was not significant (p = 0.49). In analyses adjusted by age, education, and parental abuse of alcohol, the linear trend of higher TL with increasing ACEs was confirmed (p = 0.02), and the mean difference in TL between groups remained significant (p = 0.002). The unexpected positive relationship between low education and ACEs with TL suggests that older adults who have survived harsh conditions prevailing in Northeast Brazil have the longest TL of their birth cohort.
MeSH term(s)	Aged ; Alcoholism/pathology ; Brazil ; Educational Status ; Female ; Humans ; Life Change Events ; Parents ; Regression Analysis ; Telomere Shortening/genetics
Language	English
Publishing date	2017-06-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2150779-X
ISSN	1557-8577 ; 1549-1684
ISSN (online)	1557-8577
ISSN	1549-1684
DOI	10.1089/rej.2017.1937
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Zs.A 5215: Show issues

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Article ; Online: Genetic Loci and Novel Discrimination Measures Associated with Blood Pressure Variation in African Americans Living in Tallahassee.

Quinlan, Jacklyn / Pearson, Laurel N / Clukay, Christopher J / Mitchell, Miaisha M / Boston, Qasimah / Gravlee, Clarence C / Mulligan, Connie J

PloS one

2016 Volume 11, Issue 12, Page(s) e0167700

Abstract: Sequencing of the human genome and decades of genetic association and linkage studies have dramatically improved our understanding of the etiology of many diseases. However, the multiple causes of complex diseases are still not well understood, in part ... ...

Abstract	Sequencing of the human genome and decades of genetic association and linkage studies have dramatically improved our understanding of the etiology of many diseases. However, the multiple causes of complex diseases are still not well understood, in part because genetic and sociocultural risk factors are not typically investigated concurrently. Hypertension is a leading risk factor for cardiovascular disease and afflicts more African Americans than any other racially defined group in the US. Few genetic loci for hypertension have been replicated across populations, which may reflect population-specific differences in genetic variants and/or inattention to relevant sociocultural factors. Discrimination is a salient sociocultural risk factor for poor health and has been associated with hypertension. Here we use a biocultural approach to study blood pressure (BP) variation in African Americans living in Tallahassee, Florida by genotyping over 30,000 single nucleotide polymorphisms (SNPs) and capturing experiences of discrimination using novel measures of unfair treatment of self and others (n = 157). We perform a joint admixture and genetic association analysis for BP that prioritizes regions of the genome with African ancestry. We only report significant SNPs that were confirmed through our simulation analyses, which were performed to determine the false positive rate. We identify eight significant SNPs in five genes that were previously associated with cardiovascular diseases. When we include measures of unfair treatment and test for interactions between SNPs and unfair treatment, we identify a new class of genes involved in multiple phenotypes including psychosocial distress and mood disorders. Our results suggest that inclusion of culturally relevant stress measures, like unfair treatment in African Americans, may reveal new genes and biological pathways relevant to the etiology of hypertension, and may also improve our understanding of the complexity of gene-environment interactions that underlie complex diseases.
MeSH term(s)	Adult ; African Americans/genetics ; Bayes Theorem ; Blood Pressure/genetics ; Discriminant Analysis ; Female ; Florida ; Genetic Loci ; Genetic Variation ; Genome, Human ; Genome-Wide Association Study ; Genotype ; Humans ; Hypertension/genetics ; Male ; Middle Aged ; Phenotype ; Polymorphism, Single Nucleotide ; Risk Factors
Language	English
Publishing date	2016
Publishing country	United States
Document type	Journal Article
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0167700
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