Abstract
The present study examines the association between life-course socioeconomic position (SEP) and hypertension (SAH), focusing on the health impacts of childhood SEP (SEPc), adult SEP (SEPa), as well as SEP mobility. Data from the Brazilian EpiFloripa Cohort Study (n = 1,720; 56% women; 55% <= 30 years) were analyzed. SAH was determined by the average of two measures of systolic and diastolic blood pressure, previous medical diagnosis or use of anti-hypertensive medication (43% of the sample was hypertensive). The main independent variables were: SEPa - participants' level of education; SEPc - parental educational attainment; and SEP mobility - the socio-economic trajectories from SEPc to SEPa. Five logistic regressions models were adjusted for sex, age or income, and were compared among each other. High SEPa was associated with a 37% reduction in the odds of SAH compared to low SEPa. High SEP over the life course was associated with 34-37% lower odds of SAH compared to persistent low SEP. Mobility models explained more of the outcome variance than the sensitive period model. The results reinforce the importance of education in the risk of SAH and the relevance of a socioeconomic mobility approach for the analysis of social inequalities in health.
Highlights
Non-communicable chronic diseases (NCD) play a prominent role in the overall global mortality rate
An important risk factor for Cardiovascular diseases (CVD) is systemic arterial hypertension (SAH)[2], which may be characterized by systolic (SBP) and diastolic blood pressures (DBP) equal to or greater than 130/80 and 140/90 mmHg3
The present study aims to examine the links between socioeconomic position (SEP) and SAH using a life-course approach with a particular focus on education in a sample of adults from a Southern Brazilian city
Summary
Non-communicable chronic diseases (NCD) play a prominent role in the overall global mortality rate. An important risk factor for CVD is systemic arterial hypertension (SAH)[2], which may be characterized by systolic (SBP) and diastolic blood pressures (DBP) equal to or greater than 130/80 (stage 1) and 140/90 mmHg (stage 2)[3]. The unequal distribution of SAH has been observed in relation to different socioeconomic indicators, such as education, income, and occupation[4,5,6], education has shown the most consistent patterns of association with SAH4,7. In Brazil, the links between low education and increased rates of SAH have been observed[8,9]
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