Department of Economics, Stellenbosch University, Stellenbosch, South Africa.
School of Population Health, University of New South Wales; The George Institute for Global Health, Sydney, NSW, Australia.
J Hum Hypertens. 2023 May;37(5):405-411. doi: 10.1038/s41371-022-00695-9. Epub 2022 May 5.
The relationship between negative events, neighbourhood characteristics, and systolic blood pressure in developing countries is not well-documented, particularly using longitudinal data. To explore this relationship, we analysed panel data from the first three waves of the South African National Income Dynamics Study using a correlated random effects model adjusted for confounding risk factors. Our sample comprised of 15,631 respondents in 2008, 14,443 respondents in 2010/2011, and 14,418 respondents in 2012, all aged above 15 years. The prevalence of at least one negative household event across the three waves was approximately 30%. In any of the three waves, the adjusted prevalence of hypertension was 23.84%. This share was 21.75% in 2008 (95% CI 18.06-25.44), 23.16% in 2010/11 (95% CI 19.18-27.14), and 18.39% in 2012 (95% CI 16.03-20.75). In our adjusted correlated random effects model, we found that systolic blood pressure was significantly higher among respondents from households that reported death of a household member (0.85 mmHg; p = 0.02) and a reduction in grant income and remittances (2.14 mm Hg; p = 0.01). We also found no significant association between systolic blood pressure and neighbourhood income level. In a country with social and economic challenges, our results indicate that grief and negative financial events are adversely associated with blood pressure, which may explain in part the significant burden of hypertension in low- and middle-income countries.
在发展中国家，负面事件、邻里特征与收缩压之间的关系尚未得到充分记录，尤其是使用纵向数据的情况下。为了探索这种关系，我们使用南非国家收入动态研究的前三轮面板数据，采用调整混杂风险因素的相关随机效应模型进行分析。我们的样本包括 2008 年的 15631 名受访者、2010/2011 年的 14443 名受访者和 2012 年的 14418 名受访者，所有受访者年龄均超过 15 岁。在这三个波次中，至少发生过一次家庭负面事件的受访者比例约为 30%。在任何一波次中，高血压的调整后患病率均为 23.84%。2008 年为 21.75%（95%CI 18.06-25.44）、2010/11 年为 23.16%（95%CI 19.18-27.14）、2012 年为 18.39%（95%CI 16.03-20.75）。在我们调整后的相关随机效应模型中，我们发现报告家庭成员死亡（0.85mmHg；p=0.02）和赠款收入及汇款减少（2.14mmHg；p=0.01）的家庭的受访者，其收缩压显著更高。我们还发现，收缩压与邻里收入水平之间无显著关联。在一个面临社会和经济挑战的国家，我们的研究结果表明，悲痛和负面财务事件与血压呈负相关，这可能部分解释了中低收入国家高血压负担过重的原因。
