Socioeconomic Gradients of Cardiovascular Risk Factors in China and India: Results from the China Health and Retirement Longitudinal Study and Longitudinal Aging Study in India

Abstract

Objectives: Cardiovascular disease has become a major public health challenge in developing countries. The goal of this study is to compare socioeconomic status (SES) gradients of cardiovascular risk factors both within and between China and India. Methods: We used data from the China Health and Retirement Longitudinal Study (CAHRLS) and the Longitudinal Aging Study in India (LASI) to analyze the associations between cardiovascular risk factors (waist circumference, body mass index, and hypertension) and SES, particularly education attainment and per capita expenditure. Results: The multivariate logistic regression analyses showed that obesity, defined by either waist circumference or body mass index, was positively correlated with higher education levels in Indian men and women, but inversely associated with education levels among Chinese women. Similar pattern was observed between education attainment and hypertension based on self-reported physician diagnosis and direct blood pressure measurements. Conclusions: SES is associated with cardiovascular risk factors in both China and India. However, the direction of this relationship varies across these two countries, suggesting that this association is not fixed, but is subjective to time and context-dependent causal pathways.