Prevalent Long-Term Trends of Hypertension in Austria: The Impact of Obesity and Socio-Demography

Großschädl, Franziska; Stolz, Erwin; Mayerl, Hannes; Rásky, Éva; Freidl, Wolfgang; Stronegger, Willibald J.

doi:10.1371/journal.pone.0140461

Cited by 10 publications

(12 citation statements)

References 30 publications

(37 reference statements)

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“…In general, hypertension risk is inversely associated with education [15], mostly among women and less consistently among men [9–11, 39]. In the Brazilian PNS data, however, the picture seemed to be more complex.…”

Section: Discussionmentioning

confidence: 99%

Educational inequalities in hypertension: complex patterns in intersections with gender and race in Brazil

Alves

Faerstein

2016

Int J Equity Health

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BackgroundHypertension is a major public health issue worldwide, but knowledge is scarce about its patterns and its relationship to multiple axes of social disadvantages in Latin American countries. This study describes the educational inequality in the prevalence of hypertension in Brazil, including a joint stratification by gender and race.MethodsWe analyzed interview-based data and blood pressure measurements from 59,402 participants aged 18 years or older at the 2013 Brazilian National Health Survey (PNS). Sociodemographic characteristics analyzed were gender (male, female), racial self-identification (white, brown, black), age (5-years intervals), and educational attainment (pre-primary, primary, secondary, tertiary). Hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg, and/or self-reported use of antihypertensive medications in the last 2 weeks. We used logistic regression to evaluate the age-adjusted prevalences of hypertension (via marginal modeling), and pair-wise associations between education level and odds of hypertension. Further, the educational inequality in hypertension was summarized through the Relative Index of Inequality (RII) and the Slope Index of Inequality (SII). All analyses considered the appropriate sampling weights and intersections with gender, race, and education.ResultsAge-adjusted prevalence of hypertension was 34.0 % and 30.8 % among men and women, respectively. Black and brown women had a higher prevalence than whites (34.5 % vs. 31.8 % vs. 29.5 %), whereas no racial differences were observed among men. White and brown, but not black women, showed graded inverse associations between hypertension and educational attainment; among men, non-statistically significant associations were observed in all racial strata. The RII and SII estimated inverse gradients among white (RII = 2.5, SII = 18.1 %) and brown women (RII = 2.3, SII = 14.5 %), and homogeneous distributions of hypertension in educational subgroups among black women and among men.ConclusionIn this representative sample of Brazilian adults, the association between educational attainment and hypertension was influenced by gender and race – a topic still poorly understood. Our findings highlight the importance of assessing intersections of multiple sociodemographic characteristics in health inequalities research. The use of comprehensive measures of inequality, such as RII and SII, provide useful insights for monitoring health inequalities in an intersectional perspective.

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Section: Discussionmentioning

confidence: 99%

Educational inequalities in hypertension: complex patterns in intersections with gender and race in Brazil

Alves

Faerstein

2016

Int J Equity Health

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“…In Western Europe, systolic BP decreased by 2.0 mmHg per decade in men and by 3.5 mmHg or more in women [ 21 ]. The increasing prevalence of obesity and sedentary lifestyle are usually indicated as factors contributing to the adverse trend in arterial hypertension [ 22 , 23 ]. Our data confirmed the increase in the mean BMI of Lithuanian men.…”

Section: Discussionmentioning

confidence: 99%

Trends in major risk factors and mortality from main non-communicable diseases in Lithuania, 1985–2013

et al. 2016

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BackgroundThis study aimed to assess the trends in the prevalence and levels of risk factors and mortality from main non-communicable diseases in the Lithuanian population aged 45–64 years during 1985 to 2013.MethodsData from four general population surveys conducted between 1985 and 2008 were used. All these surveys were carried out in Kaunas city and five randomly selected municipalities of Lithuania. Risk factors measured at each survey included regular smoking, overweight, obesity, arterial hypertension, and high levels of blood lipids. In total, data of 10,719 subjects (4,965 men and 5,754 women) aged 45–64 were analysed. Trends in standardized all-cause mortality and mortality from cardiovascular disease (CVD), coronary heart disease (CHD), and malignant neoplasms were estimated for both sexes by joinpoint regression analysis.ResultsIn 1985–2013, some favourable trends were observed in the age-standardized mean levels and prevalence of risk factors and mortality from main non-communicable diseases in the Lithuanian middle-aged population. The mean values of blood lipids (with the exception of triglycerides) and the prevalence of dyslipidemias declined. In women, mean levels of systolic blood pressure and body mass index decreased, while in men, the levels of these factors increased. The prevalence of arterial hypertension and obesity increased in men. The proportion of obese women decreased. Smoking prevalence increased in both men and women. From 2007 to 2008, significant downward trends, which were steeper in women than in men, were observed in all-cause, CVD, and CHD mortality.ConclusionsDespite the favourable changes in some risk factors and mortality rates, the prevalence of risk factors and mortality from main non-communicable diseases in Lithuania are still high. This indicates the importance of the ongoing primary and secondary prevention and optimal treatment of these diseases.

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“…Previous studies have shown that a low SES is associated with worse health, an enhanced prevalence of diseases (Bauer et al, 2009; Burkert, Rásky & Freidl, 2012; Burkert et al, 2012, 2013a, 2013b; Freidl et al, 2001; Holstein et al, 2009; Mackenbach, 2006; Marmot, 2007; Marmot & Wilkinson, 2005; Menke, Streich & Rössler, 2003; Österreichisches Bundesinstitut für Gesundheitswesen (ÖBIG), 2003), and a life expectancy lower by 7 years (The Marmot Review, 2010). Additionally, overweight and obesity are also related to an increased health risk to suffer from diseases (Burkert et al, 2012, 2013a, 2013b; Großschädl et al, 2015; Kiefer et al, 2006; Österreichisches Bundesinstitut für Gesundheitswesen (ÖBIG), 2003) and more mental health problems (Stranges et al, 2014). The results of this study have shown that a low SES as well as a body weight in the obese category is associated with worse self-perceived health, a higher number of chronic conditions as well as more impairment due to ill health.…”

Section: Discussionmentioning

confidence: 99%

“…Lower ratings of health as well as poor health-related behavior in general seem to be associated with obesity (Burkert, Rásky & Freidl, 2012). With rising body mass index (BMI) the risk of ill health increases: Overweight and obesity are associated with an increased health risk to suffer from diseases like diabetes, hypertension, coronary heart disease, osteoarthritis, or hormone-dependent sorts of cancer (Österreichisches Bundesinstitut für Gesundheitswesen (ÖBIG), 2003; Kiefer et al, 2006; Großschädl et al, 2015). Additionally, obesity is associated with less healthy lifestyle, psychological problems and a lower quality of life (Branca, Nikogosian & Lobstein, 2007; Brennan et al, 2009; Kiefer et al, 2006; Kinge & Morris, 2010).…”

Section: Introductionmentioning

confidence: 99%

Pronounced social inequality in health-related factors and quality of life in women and men from Austria who are overweight or obese

Burkert

Freidl

2019

PeerJ

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Background The burden of social inequalities in health as well as the association between obesity with morbidity and mortality is a worldwide problem. Therefore, the aim of our study was to investigate health-related factors, health, and quality of life in Austrian women and men with normal weight, overweight, and obesity with a different socioeconomic status (SES) based on actual data from 2015. Methods This representative population-based study was based on self-reported data of 15,338 Austrian adults (8,425 women and 6,933 men) in 2014/2015. Data of the Austrian Health Interview Survey was analyzed stratified by sex and adjusted for age concerning health-related behavior, health, and quality of life. Results The results have shown that people with a low SES differ significantly from those of high SES concerning health-related factors (e.g., eating behavior, physical activity), health and impairment due to chronic conditions, as well as quality of life. Obesity in women and men was associated with poorer health-related factors and more chronic conditions as well as unfavorable psychological aspects. In women, the results showed a significant body mass index*SES interaction for impairment due to disorders, the number of chronic conditions and quality of life in the domain of physical health. In men, the interaction was significant regarding alcohol consumption, as well as health impairment. The SES has a strong negative impact on health which implies that people of low SES have more health problems which especially concerns individuals who are obese. Therefore, a continuous target group-oriented, non-discriminatory, interdisciplinary public health program is required, prioritizing women, and men with obesity with a low SES.

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Prevalent Long-Term Trends of Hypertension in Austria: The Impact of Obesity and Socio-Demography

Cited by 10 publications

References 30 publications

Educational inequalities in hypertension: complex patterns in intersections with gender and race in Brazil

Educational inequalities in hypertension: complex patterns in intersections with gender and race in Brazil

Trends in major risk factors and mortality from main non-communicable diseases in Lithuania, 1985–2013

Pronounced social inequality in health-related factors and quality of life in women and men from Austria who are overweight or obese

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