Association of socioeconomic status with hypertension prevalence and control in Nanjing: a cross-sectional study

Zhenzhen Qin; Chao Li; Shengxiang Qi; Hairong Zhou; Jie Wu; Weiwei Wang; Qing Ye; Huafeng Yang; Chenchen Wang; Xin Hong

doi:10.1186/s12889-022-12799-5

Association of socioeconomic status with hypertension prevalence and control in Nanjing: a cross-sectional study

BMC Public Health. 2022 Mar 2;22(1):423. doi: 10.1186/s12889-022-12799-5.

Authors

Zhenzhen Qin^#¹, Chao Li^#², Shengxiang Qi¹, Hairong Zhou¹, Jie Wu¹, Weiwei Wang¹, Qing Ye¹, Huafeng Yang¹, Chenchen Wang¹, Xin Hong^{3

4}

Affiliations

¹ Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control & Prevention, 2, zizhulin, Nanjing, 210003, China.
² Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211116, China.
³ Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control & Prevention, 2, zizhulin, Nanjing, 210003, China. nj_hongxin@126.com.
⁴ Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211116, China. nj_hongxin@126.com.

^# Contributed equally.

Abstract

Background: 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.

Methods: 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).

Results: 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).

Conclusion: 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.

Keywords: Adults; Cross-sectional Study; Hypertension Control; Hypertension Prevalence; Socioeconomic Status.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Antihypertensive Agents* / therapeutic use
Blood Pressure
Cross-Sectional Studies
Humans
Hypertension* / drug therapy
Prevalence
Social Class

Substances

Antihypertensive Agents