Relative Impact of Socioeconomic Status on Blood Pressure: Lessons From a Large-Scale Survey of Young Adults

Abstract

Although several studies reported on the association between socioeconomic status (SES) and hypertension, the results are conflicting, the quantification is problematic, only a few focused on young adults, and the effects of various key determinants of SES, such as education and job type, need further clarification. We aimed to assess the influence of SES on blood pressure in a large population of young adults. We studied 11,053 male Israel Defense Force officers who underwent periodic medical evaluation during the years 1991 to 1999. Subjects completed a detailed medical questionnaire and underwent physical examination. We calculated mean systolic and diastolic blood pressure (SBP and DBP, respectively) by level of education, rank, and job type (as measures of SES), adjusting for demographic variables and body mass index (BMI). Adjusted means of SBP and DBP were highest among low-ranking officers (SBP, 119 mm Hg, compared with 117 and 115 mm Hg among intermediate and high-ranking officers, respectively, P < .001; DBP, 77 mm Hg, compared with 76 mm Hg among intermediate and high-ranking officers, P = .001). No differences were observed for level of education, but the mean SBP was higher among office workers (117 mm Hg v 116 mm Hg among physical workers, P = .038). The partial eta(2) for rank, age, and BMI was found to be 0.003, 0.008, and 0.066, respectively, for SBP, and 0.002, 0.026 and 0.054, respectively, for DBP. Low SES, as reflected by low rank, is associated with elevated blood pressure. However, as a whole, SES is a weak determinant of blood pressure compared with age and BMI.