Socioeconomic inequalities in blood pressure: co-ordinated analysis of 147,775 participants from repeated birth cohort and cross-sectional datasets, 1989 to 2016

MedRxiv : the Preprint Server for Health Sciences
David BannS. Scholes

Abstract

Objective: To evaluate whether socioeconomic inequalities in blood pressure (BP) have changed from 1989 to 2016 - a period in which average BP levels declined and the detection and treatment of high BP increased. Design Repeated observational studies. Setting: 3 nationally representative British birth cohort studies - born in 1946, 1958, and 1970 - and 21 nationally representative cross-sectional studies (Health Survey for England 1994 to 2016, HSE). Participants: 147,775 participants with BP outcomes at age 42-46 years (cohorts) or 25 years and over (HSE). Main outcome measure: Absolute differences in systolic BP (SBP) by educational attainment (cohorts and HSE) and early life social class (cohorts). Results: In both datasets, lower education was associated with higher SBP, with similar absolute magnitudes of inequality across the studied period. Differences in SBP by education (Slope Index of Inequality) based on HSE data were 3.0mmHg (95% CI: 1.8, 4.2) in 1994 and 4.3mmHg (2.3, 6.3) in 2016. Findings were similar for diastolic BP (DBP) and survey-defined hypertension. Cohort data suggested that disadvantage in early and adult life had cumulative independent associations with BP: cohort-pooled differences in SBP were 4.9mmHg ...Continue Reading

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