Mortality trends from hypertension in Mexico by socioeconomic region and state, 2000-2008

OBJECTIVE: To determine mortality trends from hypertension in Mexico nationwide, by state, by socioeconomic region, and by sex and to establish an association between education, state of residence, and socioeconomic region with mortality from hypertension in 2000-2008. METHODS: Records of mortality associated with hypertension for 2000-2008 were obtained from the National Information System of the Secretariat of Health. This information is generated by the National Institute of Statistics, Geography and Informatics through death certificates issued throughout the country. International Classification of Diseases, 10th Revision, codes corresponding to the basic cause of death from hypertension were identified. Rates of mortality nationwide, by state, and by socioeconomic region were calculated. The strength of association (obtained by Poisson regression) between states where individuals resided, socioeconomic regions, and education with mortality from hypertension was determined. The seven socioeconomic regions were elaborated by the National Institute of Statistics, Geography and Informatics and include the 31 states and Mexico City according to indicators that are related to well-being such as education, occupation, health, housing, and employment. RESULTS: Individuals who did not complete elementary school had a higher risk of dying from hypertension than people with more or no education [relative risk (RR) 1.462, 95% confidence interval (CI) 1.442-1.482]. Mexico City, Oaxaca, and region 7 had the strongest association with dying from hypertension [Mexico City: RR 2.6, CI 2.1-3.2 (2000) and RR 2.5, CI 2.1-3.1 (2005); Oaxaca: RR 2.4, CI2.0-3.0 (2006) and RR 2.7, CI2.3-3.3 (2008); region 7: RR 1.58, CI 1.45-1.72 (2000) and RR 1.25, CI 1.17-1.34 (2008)]. CONCLUSIONS: Age-adjusted mortality rates per 100 000 inhabitants who died from hypertension increased from 15.7 to 18.5 between 2000 and 2008, taking the world population age distribution as standard. Mortality was higher in women than in men and in individuals who did not complete elementary school than in those with more or no education. The strongest associations were in Mexico City, Oaxaca, and region 7.