Portland State University, Portland, OR 97207, United States.
Soc Sci Med. 2010 Mar;70(6):844-9. doi: 10.1016/j.socscimed.2009.11.019. Epub 2010 Jan 14.
Hypertension is one of the most common chronic conditions worldwide. There is strong evidence that low socioeconomic status is associated with elevated rates of blood pressure-related cardiovascular disease. Few studies have examined the association between socioeconomic circumstances and hypertension among people aged 65 years and older. The purpose of this study was to examine the relationship between household income and self-reported hypertension prevalence among persons aged 65 and older in the United States and Canada. Data were obtained from the 2002-2003 Joint Canada/United States Survey of Health for 755 Canadian and 1151 US adults aged 65 and older. Aggregate hypertension prevalence rates in the United States and Canada were generally similar (53.8% versus 48.0%). We found a significant inverse linear relationship between household income and the hypertension prevalence rate in the United States, but no evidence of such a relationship in Canada. In Canada, unlike the United States, the burden of hypertension is approximately equal for socioeconomically advantaged and disadvantaged older adults. It is important to consider these findings in the context of long-term and broader institutional policies. Social disparities and barriers to health care access and primary prevention among non-elderly persons in the United States may play a role in the higher hypertension prevalence rate among low-income older adults.
高血压是全球最常见的慢性疾病之一。有强有力的证据表明,社会经济地位较低与血压相关的心血管疾病发病率升高有关。很少有研究调查社会经济状况与 65 岁及以上人群高血压之间的关系。本研究旨在探讨美国和加拿大 65 岁及以上人群家庭收入与自我报告高血压患病率之间的关系。数据来自于 2002-2003 年加拿大/美国联合健康调查,共有 755 名加拿大和 1151 名美国 65 岁及以上成年人参与。美国和加拿大的总体高血压患病率大致相似(53.8%对 48.0%)。我们发现美国的家庭收入与高血压患病率之间呈显著的负线性关系,但在加拿大没有证据表明存在这种关系。在加拿大,与美国不同,社会经济地位较高和较低的老年人的高血压负担大致相同。在制定长期和更广泛的机构政策时,必须考虑到这些发现。在美国,非老年人的社会差距和获得医疗保健及初级预防的障碍可能在低收入老年人中高血压患病率较高方面发挥了作用。