Affiliation:
1. Department of Community Health and Preventive Medicine, Northwestern University Medical School, Chicago, IL 60611.
Abstract
An inverse association between social class and disease has frequently been reported; education, an indicator of social class, was negatively related to blood pressure in several studies. Reasons are not clear. INTERSALT, an international study on electrolytes and blood pressure, obtained data on years of education for 10,079 adults in 52 centers in 32 countries. Data presented here are for 47 centers, omitting five where the population in the sample had no education or no differences in educational level. Regression coefficients were calculated for the education-blood pressure association in each center. An inverse association was found for men in 28 centers and for women in 38. Center coefficients were combined to give a studywide estimate of that association. When adjusted only for age, systolic pressure in men was 1.3 mm Hg higher for 10 fewer years of education (p less than 0.05) and for women 4.5 mm Hg higher (p less than 0.001). However, when adjusted also for five lifestyle factors (24-hour sodium and potassium excretion, body mass index, alcohol intake, and smoking), these estimates were reduced by about one half, and the inverse association was no longer significant for men. Similar findings were obtained for diastolic pressure. Those with less education had on average higher sodium excretion, lower potassium excretion, greater body mass, and higher alcohol intake, all factors tending to increase blood pressure. Improvement of these factors, which help explain the differences in blood pressure related to years of education, has the potential to reduce the blood pressure disadvantage associated with lower socioeconomic status.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Reference22 articles.
1. McKeown T: The Role of Medicine. Oxford Basil Blackwell 1979
2. Kitagawa E Hauser P: Differential Mortality in the United States: A Study in Socioeconomic Epidemiology. Cambridge Mass Harvard University Press 1973
3. Social class and coronary heart disease.
4. Pell S Fayerweather W: Trends in the incidence of myocardial infarction and in associated mortality and morbidity in a large employed population. N EngU Med 1985;312:1005-1011
5. Drizd T Dannenberg AL Engel A: Blood pressure levels in persons 18-74 years of age in 1976-80 and trends in blood pressure from 1960 to 1980 in the United States in National Center for Health Statistics: Vital and Health Statistics Series 11 No. 234. US Dept of Health and Human Services publication No. (PHS) 86-1684. Washington DC US Government Printing Office 1986 p 34
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