The Association between Parameters of Socioeconomic Status and Hypertension in Korea: the Korean Genome and Epidemiology Study

Abstract

We investigated the association between socioeconomic status and hypertension in Korea, a country that has experienced a dynamic socioeconomic transition. We analyzed participants of a prospective cohort study—the Korean Genome and Epidemiology Study—enrolled between 2001 and 2003. We recruited 7,089 subjects who underwent a 4-year follow up till 2007. Education and income levels, which are important parameters for socioeconomic status, were stratified into 4 groups. Education level was defined as short (≤ 6 years), mid-short (7–9 years), mid-long (10–12 years), and long (≥ 12 years). Monthly income level was stratified as low (< 500,000 KRW), mid-low (500,000–1,499,999 KRW), mid-high (1,500,000–2,999,999 KRW) or high (≥ 3,000,000 KRW). At baseline, 2,805 subjects (39.5%) were diagnosed with hypertension. Education and income levels were inversely associated with the prevalence and incidence of hypertension (P < 0.001). In multivariate analysis, a shorter duration of education was significantly associated with a higher prevalence of hypertension (P < 0.001), but income level was not (P = 0.305). During the follow-up, 605 subjects (14.2%) were newly diagnosed with hypertension. In multivariate adjusted analysis, the hazard ratios (95% confidence interval) for incident hypertension across the longer education groups were 0.749 (0.544–1.032), 0.639 (0.462–0.884), and 0.583 (0.387–0.879), compared with the shortest education group. There was no significant association between incident hypertension and income across higher income groups: 0.988 (0.714–1.366), 0.780 (0.542–1.121), and 0.693 (0.454–1.056), compared with the lowest income group. In conclusion, education and income levels are associated with the prevalence and incidence of hypertension, but only education is an independent prognostic factor in Korea.

Health-Risk Transition and 8-Year Hypertension Incidence in a Nationwide Thai Cohort Study

“…A similar result for education attainment was noted in longitudinal studies in Portugal (Pereira et al, 2012), and South Asia (Prabhakaran et al, 2017). Supportive findings were found with cross-sectional studies in Korea ; C. S. Park et al, 2016), Malaysia (Abdul-Razak et al, 2016), China (Gao et al, 2013;Ruixing et al, 2008), Brazil (Silva, Petroski, & Peres, 2012), India (Kishore et al, 2016) and the US (Ong et al, 2007). In contrast, education had no influence on blood pressure in a 7-year longitudinal study in the US (He et al, 1998) or in cross-sectional studies in United Arab Emirates (Shah et al, 2015) and Morocco (Berraho et al, 2012).…”

Hypertension in Tunisian adults attending primary care physicians (ETHNA-Tunisia)

“…Therefore, especially physicians from primary care centers should pay attention to the BMI of their hypertensive patients and encourage them to lose weight. Also, hypertension prevalence decreased in higher education consultants as proved in several studies8, 15, 16, 17 which was not demonstrated in the large study conducted by Ben Romdhane et al in the year 2004–2005 2 …”

Prevalence, Awareness, Treatment, and Control of Hypertension in Korea

“…The rates of awareness, treatment, and control of hypertension have shown to vary according to the region, sex, income, and educational levels 6,8–12 . While it is of great importance to recognize the current status in hypertension diagnosis and treatment at the country level, there are limited data published from Korea 13,14 . In Korea, a national surveillance program called the Korea National Health and Nutrition Examination Survey (KNHANES), is conducted annually since 1998 to assess the health and nutritional status at the national level 15 .…”