Can social class differentials in hypertension be explained by the general susceptibility hypothesis?

Abstract

In a population-based, cross-sectional study of 310 treated hypertensives (HT) and 288 matched normotensive controls (NT), social and biological variables were investigated. HT comprised a higher proportion of individuals in lower socioeconomic strata ( P < 0.001) and lower social class distribution (defined by occupation and educational level) than NT. However, lower estimated risks (odds ratios, OR) for hypertension were found in lower social strata than in higher ones for most biological variables. This does not support the hypothesis of an increased general susceptibility in lower social classes to standard risk factors as a main factor behind the higher prevalence of hypertension, in as much as the ORs for most variables were not higher in the lower classes than in the higher ones. Thus, there may exist some, as yet undefined, and more specific risk factors for hypertension which are more prevalent in lower social strata. Interestingly, it was demonstrated that the prevention potential regarding intervention against biological risk factors had about the same magnitude in the different social strata.