Older adults had a significantly lower risk of developing
hypertension if they performed at least 200 hours of volunteer service
in the previous year, a longitudinal survey showed.
During a 4-year follow-up, people who volunteered for at least 200 hours had 40% lower odds for new-onset hypertension as compared with older people who reported no volunteer work in the previous year.
Regular volunteerism also was associated with improved psychological well-being and physical activity, Rodlescia S. Sneed and Sheldon Cohen, PhD, of Carnegie Mellon University in Pittsburgh, reported online in Psychology and Aging.
"This association was independent of age, race/ethnicity, baseline health status, education, sex, marital status, employment status, baseline systolic/diastolic blood pressure, extroversion, and agreeableness," Sneed and Cohen reported.
"Importantly, the association persisted even after controlling for chronic illnesses measured at baseline, such as history of diabetes, cancer, stroke, lung problems, or heart problems.
This is important because these illnesses could be associated with less volunteer participation and also with greater hypertension risk."
Multiple epidemiologic studies have demonstrated significant associations between volunteerism and a reduced all-cause mortality among older adults.
Although cardiovascular disease remains the leading cause of death among older adults, few studies have examined the relationship between volunteer activity and cardiovascular outcomes, the authors noted.
Studies dating back more than 30 years have documented positive effects of volunteerism on psychological well-being, which, in turn, have been associated with blood pressure and the risk of hypertension.
Volunteerism might also have favorable effects on blood pressure by providing a means of physical activity outside the home, the authors continued.
The few reports related to volunteerism and hypertension have had notable limitations, for example, measurement of blood pressure at a single point in time, precluding the ability to distinguish new-onset from existing hypertension.
Sneed and Cohen explored more closely the association between volunteerism and hypertension risk by analyzing data from the Health and Retirement Study (HRS), a longitudinal cohort study of community-dwelling adults older than 50.
The HRS included 6,734 participants who provided information on volunteerism and blood pressure at enrollment in 2006.
After excluding participants with hypertension at baseline or who reported use of antihypertensive medication, 1,654 participants remained for analysis.
The sample had a mean age of 64.2, women accounted for 60% of the group, and 1,381 of the participants were non-Hispanic whites.
The baseline interview included items about participants' volunteer activities, including an estimate of their number of volunteerism hours for the past 12 months.
The survey also included items related to psychological well-being, which Sneed and Cohen used to develop a composite index of well-being.
Of the 1,654 participants included in the analysis, 668 (40.4%) reported some volunteer work within the previous 12 months: 1 to 49 hours, 226 (33.8%); 50 to 99 hours, 166 (24.9%); 100 to 199 hours, 105 (15.7%); and ≥200 hours, 171 (25.6%).
At the follow-up interview, 501 (30.1%) were hypertensive (>140/90 mm Hg or use of antihypertensive medications). By logistic regression analysis, five factors had significant associations with an increased risk of hypertension: older age, Hispanic ethnicity, history of diabetes, baseline systolic blood pressure, and baseline diastolic blood pressure.
In a statistical model that included all five covariates, Sneed and Cohen found that HRS participants who reported >200 hours of volunteer work had an odds ratio of 0.60 for hypertension, compared with participants who reported no voluntary activities in the previous year (95% CI 0.40-0.90).
Participants with 100 to 199 hours of volunteerism had a hypertension odds ratio of 0.78, which proved not to be statistically significant. Lower levels of volunteerism had no association with hypertension risk.
Study participants who reported 1 to 49 hours, 100 to 199 hours, and ≥200 hours of volunteer activity had improved psychological well-being compared with participants who did not volunteer (P=0.006).
Participants who reported ≥200 hours of volunteerism also had higher levels of physical activity (P=0.04). The addition of psychological well-being or physical activity to the model did not significantly affect the association between volunteerism and hypertension risk.
"This study has broad implications," Sneed and Cohen said in conclusion. "Hypertension is an important, modifiable risk factor for cardiovascular disease and mortality among older adults.
This is the first study to prospectively evaluate the association of volunteerism with hypertension risk. Our findings suggest that volunteerism may be an effective non pharmacological intervention for reducing hypertension risk."
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During a 4-year follow-up, people who volunteered for at least 200 hours had 40% lower odds for new-onset hypertension as compared with older people who reported no volunteer work in the previous year.
Regular volunteerism also was associated with improved psychological well-being and physical activity, Rodlescia S. Sneed and Sheldon Cohen, PhD, of Carnegie Mellon University in Pittsburgh, reported online in Psychology and Aging.
"This association was independent of age, race/ethnicity, baseline health status, education, sex, marital status, employment status, baseline systolic/diastolic blood pressure, extroversion, and agreeableness," Sneed and Cohen reported.
"Importantly, the association persisted even after controlling for chronic illnesses measured at baseline, such as history of diabetes, cancer, stroke, lung problems, or heart problems.
This is important because these illnesses could be associated with less volunteer participation and also with greater hypertension risk."
Multiple epidemiologic studies have demonstrated significant associations between volunteerism and a reduced all-cause mortality among older adults.
Although cardiovascular disease remains the leading cause of death among older adults, few studies have examined the relationship between volunteer activity and cardiovascular outcomes, the authors noted.
Studies dating back more than 30 years have documented positive effects of volunteerism on psychological well-being, which, in turn, have been associated with blood pressure and the risk of hypertension.
Volunteerism might also have favorable effects on blood pressure by providing a means of physical activity outside the home, the authors continued.
The few reports related to volunteerism and hypertension have had notable limitations, for example, measurement of blood pressure at a single point in time, precluding the ability to distinguish new-onset from existing hypertension.
Sneed and Cohen explored more closely the association between volunteerism and hypertension risk by analyzing data from the Health and Retirement Study (HRS), a longitudinal cohort study of community-dwelling adults older than 50.
The HRS included 6,734 participants who provided information on volunteerism and blood pressure at enrollment in 2006.
After excluding participants with hypertension at baseline or who reported use of antihypertensive medication, 1,654 participants remained for analysis.
The sample had a mean age of 64.2, women accounted for 60% of the group, and 1,381 of the participants were non-Hispanic whites.
The baseline interview included items about participants' volunteer activities, including an estimate of their number of volunteerism hours for the past 12 months.
The survey also included items related to psychological well-being, which Sneed and Cohen used to develop a composite index of well-being.
Of the 1,654 participants included in the analysis, 668 (40.4%) reported some volunteer work within the previous 12 months: 1 to 49 hours, 226 (33.8%); 50 to 99 hours, 166 (24.9%); 100 to 199 hours, 105 (15.7%); and ≥200 hours, 171 (25.6%).
At the follow-up interview, 501 (30.1%) were hypertensive (>140/90 mm Hg or use of antihypertensive medications). By logistic regression analysis, five factors had significant associations with an increased risk of hypertension: older age, Hispanic ethnicity, history of diabetes, baseline systolic blood pressure, and baseline diastolic blood pressure.
In a statistical model that included all five covariates, Sneed and Cohen found that HRS participants who reported >200 hours of volunteer work had an odds ratio of 0.60 for hypertension, compared with participants who reported no voluntary activities in the previous year (95% CI 0.40-0.90).
Participants with 100 to 199 hours of volunteerism had a hypertension odds ratio of 0.78, which proved not to be statistically significant. Lower levels of volunteerism had no association with hypertension risk.
Study participants who reported 1 to 49 hours, 100 to 199 hours, and ≥200 hours of volunteer activity had improved psychological well-being compared with participants who did not volunteer (P=0.006).
Participants who reported ≥200 hours of volunteerism also had higher levels of physical activity (P=0.04). The addition of psychological well-being or physical activity to the model did not significantly affect the association between volunteerism and hypertension risk.
"This study has broad implications," Sneed and Cohen said in conclusion. "Hypertension is an important, modifiable risk factor for cardiovascular disease and mortality among older adults.
This is the first study to prospectively evaluate the association of volunteerism with hypertension risk. Our findings suggest that volunteerism may be an effective non pharmacological intervention for reducing hypertension risk."
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