Key result
Lower socioeconomic status, particularly having no education, was associated with higher hypertension prevalence compared with higher levels of education (OR 2.29; 95% CI 2.05-2.56).
Why the study?
Socioeconomic status and ethnicity both influence hypertension prevalence and control rates, but their separate contributions remain unknown.
Does lower socioeconomic status affect hypertension prevalence, awareness, treatment, and control across different ethnic groups?
Cohort (n=18,106)
Does lower socioeconomic status affect hypertension prevalence, awareness, treatment, and control across different ethnic groups?
Lower socioeconomic status is associated with higher hypertension prevalence and poorer blood pressure control, with the impact of education on treatment varying by ethnicity.
Answers are grounded in this paper and cite their sources.
May support equity-focused hypertension screening; leaves open causal effects and ethnic variations in awareness or control.
BACKGROUND: Socioeconomic status (SES) and ethnicity are both important determinants of hypertension prevalence and control rates but their separate contribution is unknown. We assessed the association of SES with hypertension prevalence, awareness, treatment and control, and whether this differs between ethnic groups. METHODS: We used baseline data from the Healthy Life in an Urban Setting (HELIUS) study, a multiethnic population-based cohort study, including 18 106 participants (84% of the total cohort) of Dutch (n = 4262), African Surinamese (n = 3732), Moroccan (n = 2902), Turkish (n = 2694), South-Asian Surinamese (n = 2664) and Ghanaian (n = 1947) descent with data on SES and hypertension status. RESULTS: Regardless of ethnicity, lower SES was associated with higher hypertension prevalence, especially in participants with no education compared with those with higher levels of education [OR 2.29 (2.05-2.56)]. There was an inverse association between SES and hypertension treatment with the strongest association for lower compared with higher educated participants [OR 1.63 (1.39-1.90)]. In addition, lower SES was associated with lower hypertension control with the strongest association for participants with the lowest compared with the highest occupational level [OR 0.76 (0.60-0.95)]. The association between educational level and treatment but not the other SES- or hypertension-indicators, was influenced by ethnicity, with lower educated Dutch and African Surinamese having higher ORs for hypertensive treatment [Dutch OR 1.98 (1.43-2.76); African Surinamese OR 1.44 (1.10-1.89)]. CONCLUSION: SES, in particular education, impacts hypertension treatment in the Netherlands, whereas the association of specific SES parameters with hypertension indicators differ across ethnic groups. Further exploration is needed on how sociocultural beliefs and behaviours may differentially affect blood pressure control across ethnic minority populations.
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A 2022 study conducted a cohort in Hypertension (n=18,106). Lower socioeconomic status (SES) vs. Higher socioeconomic status (SES) was evaluated on Hypertension prevalence (OR 2.29, 95% CI 2.05-2.56). Lower socioeconomic status, particularly having no education, was associated with higher hypertension prevalence compared with higher levels of education (OR 2.29; 95% CI 2.05-2.56).
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