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Socioeconomic Status is Related to Urinary Catecholamines in the Coronary Artery Risk Development in Young Adults (CARDIA) Study

From the Departments of Psychology (D.J.-D., S.C.), Carnegie Mellon University, Pittsburgh, Pennsylvania; Department of Psychology (N.E.A.), University of California, San Francisco, California; Department of Psychiatry (J.E.S.), State University of New York at Stony Brook, Stony Brook, New York; Department of Psychiatry (K.A.M.), University of Pittsburgh, Pittsburgh, Pennsylvania; and Division of Geriatrics (T.S.), UCLA School of Medicine, Los Angeles, California.

Objective: To determine whether socioeconomic status (SES) is associated with catecholamine levels (epinephrine [E] and norepinephrine [NE]—indicators of sympathetic nervous system [SNS] activity) in a community-based sample of men and women, Blacks and Whites, with a broad range of income; and to test whether such a relationship is mediated by psychosocial factors and/or health behaviors.

Methods: A total of 672 participants from the Coronary Artery Risk Development in Young Adults study (CARDIA) provided 12-hour, overnight urine samples, and completed sociodemographic, health behavior, and psychosocial questionnaires.

Results: Regardless of whether measured in terms of income, education, or occupation, higher SES was associated with lower urinary catecholamine levels, independent of age, race, and gender. These relationships were stronger in men than in women but were similar across Blacks and Whites. Smoking and greater levels of depressive symptoms accounted for some of the association of SES with E and, to a lesser extent, with NE.

Conclusions: These data provide support for the hypothesis that lower SES is accompanied by increased physiologic distress, indicated by elevated SNS activity. Further, they suggest that the association of SES with catecholamines, like the associations of SES with morbidity and mortality, is apparent at all levels of the socioeconomic hierarchy.

Key Words: socioeconomic status • catecholamines • sympathetic nervous system • CARDIA • health behaviors

Abbreviations: SES = socioeconomic status; SNS = sympathetic nervous system; E = epinephrine; NE = norepinephrine; CARDIA = Coronary Artery Risk Development in Young Adults study; BMI = body mass index.