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Socioeconomic disparities and risk of hypertension among older Americans

Abstract : Background Reducing hypertension represents a critical point of intervention to lower the burden of cardiovascular disease worldwide. Although the relationship between lower socioeconomic status and higher rates of hypertension is well documented, most of the evidence comes from prevalence studies involving young adult population. Aim To investigate the independent association of wealth, education and income with incident hypertension among older adults living in the United States. Methods This cohort study included 16 587 individuals aged 50 years and older, free of hypertension and cardiovascular disease at baseline from the Health and Retirement Study over the period 1992-2014. We used Cox proportional hazards models to examine longitudinal associations between wealth, education, and income at baseline and self-reported diagnosis of incident hypertension. Results During a median follow-up of 7.8 years, 6817 participants declared an occurrence of hypertension (incidence rate: 45.3 [95% confidence interval (CI) = 44.2-46.4] per 1000 person-years). Overall, those in low as compared with high socioeconomic status groups had a higher risk of developing hypertension in late life. In particular, adjusted hazard ratios [95% CI] across decreasing wealth quartiles were 1.0 (reference), 0.97 [0.88-1.08], 1.17 [1.05-1.30], and 1.20 [1.07-1.35] in men, and 1.0 (reference), 1.28 [1.17-1.41], 1.21 [1.09-1.33], and 1.28 [1.16-1.42] in women. In multivariate analyses, wealth remained strongly associated with incident hypertension among women after accounting for other socioeconomic, behavioral and anthropometric risk factors. Conclusions Socioeconomic status, especially wealth, is a strong independent predictor of incident hypertension in older adults. Our findings support population-based interventions tailored to those in disadvantaged socioeconomic groups to reduce the risk of hypertension.
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https://hal.ehesp.fr/hal-03323188
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Submitted on : Friday, August 20, 2021 - 2:52:17 PM
Last modification on : Saturday, August 21, 2021 - 3:27:09 AM

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Lola Neufcourt, Marie Zins, Lisa Berkman, Olivier Grimaud. Socioeconomic disparities and risk of hypertension among older Americans. Journal of Hypertension, Lippincott, Williams & Wilkins, 2021, Publish Ahead of Print, ⟨10.1097/hjh.0000000000002959⟩. ⟨hal-03323188⟩

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