Socio-economic status and blood pressure: an overview analysis

Abstract

Background: Mortality rates from hypertension relatedThe finding of an SES gradient in BP, despite adjusting for treatment in some studies and the lack of consistent diseases such as coronary heart disease, hypertensive heart disease, stroke and end stage renal disease show SES differences in hypertension treatment rates, makes differential treatment an unlikely explanation for the SES an inverse association with socio-economic status (SES). gradient in BP. A substantial part of the SES gradient was accounted for by the SES gradient in body mass Objectives: To review the published literature in order to assess whether (i) there is an association between index. Alcohol consumption across SES groups accounted for part of the association in men though few SES and blood pressure (BP), and if so whether this is explained by (ii) SES differences in treatment rates, or studies examined this issue specifically. In contrast, in undeveloped or developing countries a direct associ-(iii) SES differences in established risk factors for hypertension, or (iv) psycho-social factors associated ation between SES and BP has often been found which may reflect a higher prevalence of obesity, and higher with SES. Method: A narrative systematic review of published artsalt and alcohol intakes among those of higher SES. The SES differences in BP were not detectable in most studicles identified from a MEDLINE search from 1966-1996 and manual searching of the retrieved articles' biblioies in children. There is little evidence that adverse psycho-social factors associated with low SES cause graphies. Results: Lower SES was associated with higher mean chronic elevations in BP. Conclusion: A major challenge in reducing the SES BPs in almost all studies in developed countries. This inverse gradient was both stronger and more consistgradient in BP is to understand and prevent the SES differences in obesity, which are particularly large in ently found in women than in men. The magnitude of the association varied but generally was quite small, women. Future research should be directed to this question. with age adjusted mean systolic BP differences of about 2-3 mm Hg between the highest and lowest SES groups.

Gender differences in prevalence and socioeconomic determinants of hypertension: findings from the WHO STEPs survey in a rural community of Vietnam

“…7 In summary, our findings showed that hypertension in rural Vietnam is becoming a serious problem, which should no longer be ignored, both because of its magnitude and the unacceptably high unawareness rate in the population.…”

“…This inverse association was also found in almost all studies carried out in developed countries such as the United States of America, Canada, Australia, Sweden and the Netherlands. 7 In developing countries, the pattern of association varied: meanwhile, hypertension was found to be inversely associated with educational levels in some studies, for example, in Brazil 39 and China, 40 while a direct association was observed in others, for example in India. 41,42 Mortality from cardiovascular disease in Bavi in 2000 was also higher among less educated people but the difference was not statistically significant.…”

“…Blood pressure levels and hypertension have been proven to be inversely related to socioeconomic status in developed countries, [6][7][8] but in the developing world such correlations have not always been evident. [7][8][9][10][11][12] Vietnam, a developing country in Southeast Asia, is undergoing an early stage of health transition where the population is suffering from the 'double burden' of old communicable diseases and emerging noncommunicable diseases (NCDs). 13 According to hospital statistics, hypertension was the third contributor to the burden of death and the sixth contributor to the burden of disease in hospitals for the whole country in 2002.…”

Blood pressure and aging

“…However most of this effect can be explained by an increased proportion of obese subjects and higher alcohol intake in the most deprived socioeconomic groups. 16 Similar relationships exist for educational status. 17 Environmental influences early in life may affect blood pressure as an adult and into old age.…”

Higher blood pressure in middle-aged American adults with less education—role of multiple dietary factors: The INTERMAP Study

“…Special efforts to improve eating patterns of less educated strata can contribute importantly to overIntroduction An inverse relationship between education and blood pressure (BP) of individuals has been found repeatedly in cross-sectional surveys of US population samples of varied ethnicities and in many other population samples, particularly from economically developed countries. [1][2][3][4][5][6][7][8][9][10][11][12][13] Correspondingly, the CAR-DIA and Western Electric prospective studies found that people with less educational attainment at baseline experienced greater BP increase over the ensuing years. 14,15 Little information is available on factors accounting for these findings.…”