Contributions of Social Context to Blood Pressure: Findings From a Multilevel Analysis of Social Capital and Systolic Blood Pressure
Contributions of Social Context to Blood Pressure: Findings From a Multilevel Analysis of Social Capital and Systolic Blood Pressure
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DOI：
10.1038/ajh.2011.37
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发表时间：
2011-06-01
影响因子：
3.2
通讯作者：
Shiwaku, Kuninori
中科院分区：
文献类型：
--
作者：
Hamano, Tsuyoshi;Fujisawa, Yoshikazu;Shiwaku, Kuninori
背景近年来，很少有研究量化居住环境对血压的影响。虽然这些研究强调了教育或贫困水平等社会经济影响的重要性，但社会资本等社会结构特征与血压之间的关联仍不清楚。因此，我们调查社会资本是否与收缩压控制后的个人潜在confounders.METHODS我们分析了从2006年至2008年在日本农村山区进行的岛根研究的数据。在排除了缺失数据和服用高血压药物的参与者的数据后，我们对335名嵌套在30个邮政编码区的个体的数据进行了多层次分析。我们还发现，在吸烟者和服用糖尿病药物的人中观察到较高的收缩压。关于社会资本的背景效应，收缩压增加的比例越来越多的缺乏公平性，调整后的个人confuers.CONCLUSIONSTO我们所知，这项研究是第一次调查社会资本和收缩压之间的关联，通过使用一个多层次的方法框架。令人惊讶的是，我们发现缺乏公平对收缩压有很大的影响。然而，我们没有发现社会资本的其他项目和收缩压之间有任何显着的关联。需要进一步的研究来阐明缺乏公平性可能对收缩压产生影响的机制。
BACKGROUNDIn recent years, few studies have quantified the effect of residential context on blood pressure. Although these studies have emphasized the importance of socioeconomic influences such as education or poverty levels, the association between the features of social structure such as social capital and blood pressure remain unclear. Therefore, we investigated whether social capital was associated with systolic blood pressure after controlling for individual potential confounders.METHODSWe analyzed data from the Shimane Study conducted from 2006 to 2008 in rural mountainous regions of Japan. After excluding the missing data and data of participants taking hypertension medication, we conducted a multilevel analysis of the data for 335 individuals nested within 30 postcode sectors.RESULTSSystolic blood pressure increased with increasing age and body mass index. We also found that a higher systolic blood pressure was observed among smokers and those taking medication for diabetes. Regarding the contextual effects of social capital, systolic blood pressure increased with an increasing proportion of lack of fairness, after adjustment for individual confounders.CONCLUSIONSTo the best of our knowledge, this study is the first to investigate the association between social capital and systolic blood pressure by using a multilevel methodological framework. Surprisingly, we found that lack of fairness had a strong effect on systolic blood pressure. However, we could not find any significant associations between other items of social capital and systolic blood pressure. Further studies are needed to clarify the mechanism by which lack of fairness may have an effect on systolic blood pressure.