Abstract P355: Religious Attendance, Educational Attainment, and Hypertension. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Abstract

Introduction: The relationship between the level of religiosity and health-adverse outcomes has been controversial. One reason should be that how "religiosity" is measured or by a self-declaration (meaning more a cultural variable than a manifestation of the spirituality) of by regular religious practices attendance. Several studies pointed out that educational attainment has a close relationship with the practice of religion. In Brazil, the non-practice religious persors have a higher level of formal education than the general population. Therefore, researchers have focused on risk factors, such as hypertension, studying the effect of religious service attendance, besides other religious dimensions, on blood pressure. Hypothesis: This study has a premise that attending to religious ceremonies are associated with hypertension according to levels of education. Methods: At baseline of the ELSA-Brasil study (15105 adults aged 35-74years old), we asked about the frequency of attendance to religious services. Hypertension was defined as systolic or diastolic blood pressures higher than 140/90 mm Hg or under antihypertensive drugs. Educational attainment was categorized as less or more than high school.Logistic regression models were used to obtain odds ratio (OR) and 95% confidence intervals (95%CI) for the association between frequency of attendance and hypertension adjusted for age, sex, race, income, physical activity and salt consumption (estimated by 12-hour urinary sodium excretion). Further, we added variables that are potential mediators of the religion-hypertension association as smoking, alcohol consumption and body-mass index, depending on the level of education. Results: Three-quarters (76.9%) of the participants reported to be religious (mean age of 51.6 years, 58.7% women; 51.8% white), and 49.8% of them declared religious attendance at least weekly. For those with a higher educational level, no association was found an inverse association between frequent religious service attendance and the presence of hypertension, also concerning sociodemographic variables, and between religious practice attendance and hypertension after adjusting for covariates (OR = 1.10, 95% CI 0.98-1.23). However, for subjects with lower educational attainment, religious attendance was inversely associated with hypertension (OR = 0.71, 95%CI 0.53-0.96), after adjusting for covariates. We did not find differences in each educational attainment strata related to association religious attendance and hypertension when stratified by gender, race, family income, and to be Roman Catholic and non-Roman Catholic. Conclusion: The effects of religious involvement on hypertension seem to diverge according to socioeconomic status, represented here by educational attainment.