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

BMC Medicine
David BannS. Scholes

Abstract

High blood pressure (BP) is a key modifiable determinant of cardiovascular disease and a likely determinant of other adverse health outcomes. While socioeconomic inequalities in BP are well documented, it remains unclear (1) how these inequalities have changed across time, given improvements over time in the detection and treatment of high BP (hypertension); (2) whether BP inequalities are present below and above hypertension treatment thresholds; and (3) whether socioeconomic position (SEP) across life has cumulative effects on BP. We sought to address these gaps using evidence from two complementary sources: birth cohort and repeated cross-sectional datasets. We used three British birth cohort studies-born in 1946, 1958, and 1970-with BP measured at 43-46 years (in 1989, 2003, and 2016), and 21 repeated cross-sectional datasets-the Health Survey for England (HSE), with BP measured among adults aged ≥ 25 years (1994-2016). Adult education attainment was used as an indicator of SEP in both datasets; childhood father's social class was used as an alternative indicator of (early life) SEP in cohorts. Adjusting for the expected average effects of antihypertensive medication use, we used linear regression to quantify SEP difference...Continue Reading

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