Systolic Blood Pressure and Socioeconomic Status in a large multi-study population

Abstract

The present study used harmonized data from eight studies (N = 28,891) to examine the association between socioeconomic status (SES) and resting systolic blood pressure (SBP). The study replicates and extends our prior work on this topic by examining potential moderation of this association by race and gender. We also examined the extent to which body mass index (BMI), waist circumference (WC), and smoking might explain the association between SES and SBP. Data were available from six race/gender groups: 9200 Black women; 2337 Black men; 7248 White women; 6519 White men; 2950 Hispanic women; and 637 Hispanic men. Multivariable regression models showed that greater annual household income was associated with lower SBP in all groups except Hispanic men. The magnitude and form of this negative association differed across groups, with White women showing the strongest linear negative association. Among Black men and Hispanic women, the association was curvilinear: relatively flat among lower income levels, but then negative among higher income ranges. Education also was independently, negatively related to SBP, though evidence was weaker for race and gender differences in the strength of the association. Higher BMI and WC were associated with higher SBP, and current smoking with lower SBP. Inclusion of these risk factors resulted in only a modest change in the magnitude of the SBP and SES relation, accounting on average about 0.4 mmHg of the effect of income and 0.2 mmHg of the effect of education—effects unlikely to be clinically significant. Further understanding of mechanisms underlying the association between SBP and SES may improve risk stratification in clinical settings and potentially inform interventions aimed at reductions in social disparities in health.

Gender Differences in Prevalence and Risk Factors for Hypertension among Adult Populations: A Cross-Sectional Study in Indonesia

“…Unlike men, low SES status was a significant risk factor for hypertension among women. In fact, poor women were those who had a more sedentary lifestyle, which was observed in this study and another recent study [ 30 ]. The research location was in Yogyakarta, an area with a strong patriarchal culture, which typically assigns domestic roles to women.…”

Socioeconomic characteristics of African American women attending community blood pressure screenings

“…African American women also have a higher prevalence of comorbidities such as obesity, diabetes, and chronic kidney disease [ 1 , 3 – 5 ], are less likely to engage in health behaviors that reduce CVD risk [ 6 ], and are less likely to be aware of HTN as a heart disease risk factor [ 7 ]. Furthermore, this group is more likely to experience socioeconomic adversity compared to white women [ 8 – 10 ]; even so, higher socioeconomic status (SES) African American women are less likely to experience health gains from their socioeconomic resources compared to white women of similar or equal SES [ 11 – 13 ].…”

“…Since prior studies have primarily focused on the efficacy and impact of BP reduction interventions [ 27 – 29 ], we were especially interested in examining whether the association between SES and BP would be different for high (versus low) SES women. While higher SES is generally associated with better health [ 13 , 23 ], extant literature suggests the SES-health gradient among higher SES African Americans is weaker or absent [ 25 , 30 – 32 ]. Thus, we hypothesized that the magnitude of association between SES and BP outcomes would be different and stronger for low versus high SES African American women.…”

Pericardial Fat, Socioeconomic Status, and Biological Responses to Acute Mental Stress

“…One reason for these discrepant findings is differences in statistical covariates. Specifically, Iacobellis et al ( 72 ) only adjusted for gender in their analyses, and Kim et al ( 33 ) did not adjust for any covariates at all, whereas we adjusted for multiple potential confounders known to correlate with both pericardial fat and blood pressure including age, SES, and central adiposity ( 5 , 30 , 73 ). Therefore, associations found in prior studies might have been confounded by sociodemographic factors or central adiposity.…”