Socioeconomic status, blood pressure progression, and incident hypertension in a prospective cohort of female health professionals
Socioeconomic status, blood pressure progression, and incident hypertension in a prospective cohort of female health professionals
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DOI：
10.1093/eurheartj/ehp072
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发表时间：
2009-06-01
影响因子：
39.3
通讯作者：
Albert, Michelle A.
中科院分区：
文献类型：
--
作者：
Conen, David;Glynn, Robert J.;Albert, Michelle A.
本研究的目的是探讨社会经济地位、血压（BP）进展和高血压事件之间的关系，我们纳入了27207名基线时无高血压和心血管疾病的女性卫生专业人员。参与者被分为五个教育和六个收入类别。主要结果变量为48个月随访时的血压进展和整个研究期间的高血压事件。在48个月时，48.1%的女性有BP进展。BP进展的多变量校正相对风险[95%置信区间（CI）]为1.0（参考），0.96（0.92-1.00）、0.92（0.88-0.96）、0.90（0.85-0.94）和0.84（0.78-0.91）（趋势P < 0.0001）在增加的教育类别和1.0（参考），1.01（0.94-1.08），0.99（0.93-1.06），0.97（0.91-1.04），0.96（0.90-1.03）和0.89（0.83-0.96）在收入增加的类别（趋势P = 0.0001）。在平均9.8年的随访中，发生了8248例高血压事件。多变量校正的风险比（95% CI）为1.0（参考），0.92（0.86-0.99）、0.85（0.79-0.92）、0.87（0.80-0.94）和0.74（0.65-0.84）（趋势P < 0.0001）在增加的教育类别和1.0（参考），1.07（0.95-1.21），1.07（0.95-1.20），1.06（0.94-1.18），1.04（0.93-1.16）和0.93（0.82-1.06）（趋势0.08的P）。在联合分析中，受教育程度而非收入与血压进展和高血压事件相关，受教育程度而非收入决定的社会经济地位是女性血压进展和高血压事件的强有力的独立预测因素。
The aim of this study was to examine the association between socioeconomic status, blood pressure (BP) progression, and incident hypertension.We included 27 207 female health professionals free of hypertension and cardiovascular disease at baseline. Participants were classified into five education and six income categories. The main outcome variables were BP progression at 48 months of follow-up and incident hypertension during the entire study period. At 48 months, 48.1% of women had BP progression. The multivariable adjusted relative risks [95% confidence intervals (CIs)] for BP progression were 1.0 (referent), 0.96 (0.92-1.00), 0.92 (0.88-0.96), 0.90 (0.85-0.94), and 0.84 (0.78-0.91) (P for trend < 0.0001) across increasing education categories and 1.0 (referent), 1.01 (0.94-1.08), 0.99 (0.93-1.06), 0.97 (0.91-1.04), 0.96 (0.90-1.03), and 0.89 (0.83-0.96) across increasing income categories (P for trend = 0.0001). During a median follow-up of 9.8 years, 8248 cases of incident hypertension occurred. Multivariable adjusted hazard ratios (95% CI) were 1.0 (referent), 0.92 (0.86-0.99), 0.85 (0.79-0.92), 0.87 (0.80-0.94), and 0.74 (0.65-0.84) (P for trend < 0.0001) across increasing education categories and 1.0 (referent), 1.07 (0.95-1.21), 1.07 (0.95-1.20), 1.06 (0.94-1.18), 1.04 (0.93-1.16), and 0.93 (0.82-1.06) (P for trend 0.08) across increasing income categories. In joint analyses, education but not income remained associated with BP progression and incident hypertension.Socioeconomic status, as determined by education but not by income, is a strong independent predictor of BP progression and incident hypertension in women.