Calixte Rose, Besson Ayanna, Chahal Kunika, Kaplan Mark S
Epidemiology and Biostatistics.
College of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York.
Blood Press Monit. 2025 Feb 1;30(1):1-10. doi: 10.1097/MBP.0000000000000726. Epub 2024 Dec 18.
Although it has long been established that age and sex play a role in blood pressure levels across the lifespan, the extent to which educational attainment moderates these relationships has been understudied. Thus, the purpose of this study was to assess educational differences in SBP, DBP, and pulse pressure (PP) trajectories among men and women through the midlife years.
We conducted an analysis of pooled data from the 1999 to 2018 National Health and Nutrition Examination Survey to assess whether education moderates blood pressure measurements among men and women over the midlife years. Statistical analyses were performed using survey-weighted linear and quadratic regressions to assess these trajectories.
During midlife, women with at least a college degree maintained the lowest average level of SBP compared to men at all education levels and women with a high school diploma or less. They also maintained the lowest level of PP, though not different from men with at least a college degree and women with less than a college degree. However, no educational differences were observed in DBP between men and women during the midlife years.
Our study shows clear delineation in the trajectories of PP and SBP by education such that a 4-year education is more protective than some college and a high school degree, particularly among women. These results highlight the need to consider upstream policy interventions (education policy initiatives) that could reduce population-wide elevated blood pressure.
尽管长期以来人们已经确定年龄和性别在整个生命周期的血压水平中起作用，但教育程度对这些关系的调节程度却研究不足。因此，本研究的目的是评估中年男性和女性收缩压（SBP）、舒张压（DBP）和脉压（PP）轨迹的教育差异。
我们对1999年至2018年国家健康与营养检查调查的汇总数据进行了分析，以评估教育程度是否会调节中年男性和女性的血压测量值。使用调查加权线性和二次回归进行统计分析，以评估这些轨迹。
在中年时期，与所有教育水平的男性以及高中文凭及以下的女性相比，至少拥有大学学位的女性的SBP平均水平最低。她们的PP水平也最低，不过与至少拥有大学学位的男性和大学学位以下的女性没有差异。然而，中年时期男性和女性在DBP方面未观察到教育差异。
我们的研究表明，PP和SBP轨迹在教育程度上有明显差异，即4年的教育比部分大学学历和高中学历更具保护作用，尤其是在女性中。这些结果凸显了考虑上游政策干预措施（教育政策倡议）以降低全人群高血压水平的必要性。
