Education as an increasing protective factor against hypertension Trends data from the last 2 decades in Brazil.

Background Hypertension is one of the leading causes of morbidity and mortality, and has a high prevalence, affecting 30 to 45% of adults globally. Social factors have been proven determinants of cardiovascular risk. However, long-term longitudinal data on the effects of education upon hypertension prevalence are scarce, specially from low and middle-income countries.Objective: To assess the effect of education upon hypertension prevalence in Brazil. Methods A serial cross-sectional analysis was conducted using 2006 to 2024 data from VIGITEL (n=833,217), a national Brazilian telephone survey of adults (≥18 years). The association between educational attainment (measured in years of schooling) and hypertension (self-reported) was assessed using multivariate logistic regression, adjusting for age, sex, obesity, type 2 diabetes mellitus, dyslipidemia and smoking history. Results The population was 38.1% male, mean age was 47.8±17.8 years, mean education was 11.0±5.0 years of schooling, and 30.6% self-reported hypertension. The prevalence of hypertension increased from 23.8% in 2006 to 28.9% in 2024, and education levels also increased from 10.1±4.4 years in 2006 to 11.8±4.7 years in 2024. Adjusted for possible confounding variables, educational attainment was a protective factor against hypertension (Std. β=-0.034, p<0.001). Furthermore, it’s protected effect increased from -0.033 (-3.3%/year of schooling) in 2006 (p<0.001), to -0.036 (-3.6%/year of schooling) in 2024 (p<0.001). Conclusion In this large study, educational was a protective factor against hypertension, and this effect increased in the last 18 years.