Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control & Prevention, 2, zizhulin, Nanjing, 210003, China.
Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211116, China.
BMC Public Health. 2022 Mar 2;22(1):423. doi: 10.1186/s12889-022-12799-5.
The role of socioeconomic status (SES) on hypertension prevalence and hypertension control has gotten much attention but with conflicting results. This paper aimed to quantify the association of SES with both hypertension prevalence and hypertension control rate in Nanjing, China.
A community-based cross-sectional study was conducted using multistage random sampling on 60,283 adults aged more than 18 years between March 2017 and June 2018. Hypertension was defined as systolic blood pressure (BP) ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg or self-reported diagnosis of hypertension or respondent's report of taking antihypertensive medications. The controlled hypertension was defined by systolic BP < 140 mmHg and diastolic BP of < 90 mmHg among the subjects that self-reported exhibiting hypertensive and taking antihypertensive medications. The associations between SES with hypertension prevalence and hypertension control were quantified using generalized mixed model regression analysis and reported as odds ratios (ORs) and 95% confidence interval (CI).
There was a high prevalence of subjects with primary educational level (49.6%) or unemployed and retired (49.5%) or lower annual household income level (44.9%) in each SES group, respectively. After adjustments for potential confounding factors, there were higher odds of hypertension among those with primary educational level (OR = 1.56), but lower odds for controlled BP (OR = 0.51). Higher odds of hypertension could be found among unemployed and retired, and higher odds of controlled BP was observed in the mental laborers or students (OR = 1.30), compared with the other categories, respectively. The lower-income group was more likely to be hypertensive (OR = 1.35) and less likely to have controlled hypertension (OR = 0.73).
Socioeconomic status played an important role in hypertension prevalence and hypertension control among adults in Nanjing, China. Strategies for hypertension prevention and control should especially focus on people in the vulnerable lower SES groups.
社会经济地位（SES）对高血压患病率和高血压控制率的影响备受关注，但结果存在争议。本研究旨在定量评估 SES 与中国南京成年人高血压患病率和高血压控制率的相关性。
采用多阶段随机抽样方法，于 2017 年 3 月至 2018 年 6 月对 60283 名年龄在 18 岁以上的成年人进行了一项基于社区的横断面研究。高血压定义为收缩压（BP）≥140mmHg 和/或舒张压（BP）≥90mmHg，或自我报告的高血压诊断，或受访者报告正在服用降压药物。控制高血压定义为自我报告患有高血压并服用降压药物的患者中收缩压<140mmHg 和舒张压<90mmHg。采用广义混合模型回归分析定量评估 SES 与高血压患病率和高血压控制率的相关性，并以比值比（OR）和 95%置信区间（CI）表示。
在每个 SES 组中，具有小学教育程度（49.6%）或失业和退休（49.5%）或较低年收入水平（44.9%）的受试者比例较高。在调整了潜在混杂因素后，与具有较高教育程度的人相比，小学教育程度（OR=1.56）的人患高血压的几率更高，但控制血压的几率（OR=0.51）更低。与其他类别相比，失业和退休人员患高血压的几率更高（OR=1.30），而脑力劳动者或学生控制血压的几率更高（OR=1.30）。与其他类别相比，低收入组患高血压的几率更高（OR=1.35），控制高血压的几率更低（OR=0.73）。
SES 在中国南京成年人的高血压患病率和高血压控制率中起着重要作用。高血压预防和控制策略应特别关注处于弱势较低 SES 群体的人群。
