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Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Gender differences in the association between socioeconomic status and hypertension incidence: the Korean Genome and Epidemiology Study (KoGES)

Authors: Tae-Hwa Baek, Hae-Young Lee, Nam-Kyoo Lim, Hyun-Young Park

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

Hypertension is a leading cause of cardiovascular events. We examined whether there was a gender difference in the association between SES, measured by education and income, and hypertension incidence.

Methods

Data for 2596 men and 2686 women aged 40–69 years without hypertension at baseline from the Korean Genome and Epidemiology Study (KoGES) were analyzed. Participants had two follow-up examinations during 4 years, and were classified into three categories by self-reported educational attainment: ≥ 10 years, 7–9 years, and 0–6 years, and monthly household income (×10,000 Korean Won): ≥ 200, 100–199, and <100. The association between SES and incidence hypertension was examined by Cox’s proportional hazard regression analyses.

Results

Adjusting for conventional risk factors, compared with the high education group (reference), the hazard ratios (95 % confidence interval) for incident hypertension across the education categories were 1.54 (1.16–2.06) and 1.80 (1.36–2.38) in women and 1.15 (0.92–1.43), and 1.08 (0.84–1.38) in men. Women with the low household income were more likely to have hypertension than those with the high household income and incident hypertension had an inverse association with household income level in women: multivariate adjusted hazard ratios were 1.00 (reference), 1.10 (0.83–1.45), and 1.63 (0.75–2.16). Men with medium income were less likely to have hypertension compared with those with high income (0.76, 0.61–0.90).

Conclusions

Educational level and economic status had stronger impacts on hypertension in Korean women than men. Thus, a stratified approach for women of low socioeconomic status, especially those with low educational attainment, is needed for the prevention of hypertension.
Literature
1.
go back to reference Kannel WB. Blood pressure as a cardiovascular risk factor: prevention and treatment. Jama. 1996;275(20):1571–6.CrossRefPubMed Kannel WB. Blood pressure as a cardiovascular risk factor: prevention and treatment. Jama. 1996;275(20):1571–6.CrossRefPubMed
2.
go back to reference Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2224–60.CrossRefPubMedPubMedCentral Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2224–60.CrossRefPubMedPubMedCentral
3.
go back to reference Colhoun HM, Hemingway H, Poulter NR. Socio-economic status and blood pressure: an overview analysis. J Hum Hypertens. 1998;12(2):91–110.CrossRefPubMed Colhoun HM, Hemingway H, Poulter NR. Socio-economic status and blood pressure: an overview analysis. J Hum Hypertens. 1998;12(2):91–110.CrossRefPubMed
4.
go back to reference Thawornchaisit P, de Looze F, Reid CM, Seubsman SA, Sleigh A, Thai Cohort Study T. Health-risk factors and the prevalence of hypertension: cross-sectional findings from a national cohort of 87,143 Thai Open University students. Glob J Health Sci. 2013;5(4):126–14.PubMedPubMedCentral Thawornchaisit P, de Looze F, Reid CM, Seubsman SA, Sleigh A, Thai Cohort Study T. Health-risk factors and the prevalence of hypertension: cross-sectional findings from a national cohort of 87,143 Thai Open University students. Glob J Health Sci. 2013;5(4):126–14.PubMedPubMedCentral
5.
go back to reference Samuel P, Antonisamy B, Raghupathy P, Richard J, Fall CH. Socio-economic status and cardiovascular risk factors in rural and urban areas of Vellore, Tamilnadu, South India. Int J Epidemiol. 2012;41(5):1315–27.CrossRefPubMedPubMedCentral Samuel P, Antonisamy B, Raghupathy P, Richard J, Fall CH. Socio-economic status and cardiovascular risk factors in rural and urban areas of Vellore, Tamilnadu, South India. Int J Epidemiol. 2012;41(5):1315–27.CrossRefPubMedPubMedCentral
6.
go back to reference Yoon YS, Oh SW, Park HS. Socioeconomic status in relation to obesity and abdominal obesity in Korean adults: a focus on sex differences. Obesity. 2006;14(5):909–19.CrossRefPubMed Yoon YS, Oh SW, Park HS. Socioeconomic status in relation to obesity and abdominal obesity in Korean adults: a focus on sex differences. Obesity. 2006;14(5):909–19.CrossRefPubMed
7.
go back to reference de Gaudemaris R, Lang T, Chatellier G, Larabi L, Lauwers-Cances V, Maitre A, et al. Socioeconomic inequalities in hypertension prevalence and care: the IHPAF Study. Hypertension. 2002;39(6):1119–25.CrossRefPubMed de Gaudemaris R, Lang T, Chatellier G, Larabi L, Lauwers-Cances V, Maitre A, et al. Socioeconomic inequalities in hypertension prevalence and care: the IHPAF Study. Hypertension. 2002;39(6):1119–25.CrossRefPubMed
8.
go back to reference Wang Y, Chen J, Wang K, Edwards CL. Education as an important risk factor for the prevalence of hypertension and elevated blood pressure in Chinese men and women. J Hum Hypertens. 2006;20(11):898–900.CrossRefPubMed Wang Y, Chen J, Wang K, Edwards CL. Education as an important risk factor for the prevalence of hypertension and elevated blood pressure in Chinese men and women. J Hum Hypertens. 2006;20(11):898–900.CrossRefPubMed
9.
go back to reference Fateh M, Emamian MH, Asgari F, Alami A, Fotouhi A. Socioeconomic inequality in hypertension in Iran. J Hypertens. 2014;32(9):1782–8.CrossRefPubMed Fateh M, Emamian MH, Asgari F, Alami A, Fotouhi A. Socioeconomic inequality in hypertension in Iran. J Hypertens. 2014;32(9):1782–8.CrossRefPubMed
10.
go back to reference Vargas CM, Ingram DD, Gillum RF. Incidence of hypertension and educational attainment: the NHANES I epidemiologic followup study. First National Health and Nutrition Examination Survey. Am J Epidemiol. 2000;152(3):272–8.CrossRefPubMed Vargas CM, Ingram DD, Gillum RF. Incidence of hypertension and educational attainment: the NHANES I epidemiologic followup study. First National Health and Nutrition Examination Survey. Am J Epidemiol. 2000;152(3):272–8.CrossRefPubMed
11.
go back to reference Conen D, Glynn RJ, Ridker PM, Buring JE, Albert MA. Socioeconomic status, blood pressure progression, and incident hypertension in a prospective cohort of female health professionals. Eur Heart J. 2009;30(11):1378–84.CrossRefPubMedPubMedCentral Conen D, Glynn RJ, Ridker PM, Buring JE, Albert MA. Socioeconomic status, blood pressure progression, and incident hypertension in a prospective cohort of female health professionals. Eur Heart J. 2009;30(11):1378–84.CrossRefPubMedPubMedCentral
12.
go back to reference Vathesatogkit P, Woodward M, Tanomsup S, Hengprasith B, Aekplakorn W, Yamwong S, et al. Long-term effects of socioeconomic status on incident hypertension and progression of blood pressure. J Hypertens. 2012;30(7):1347–53.CrossRefPubMed Vathesatogkit P, Woodward M, Tanomsup S, Hengprasith B, Aekplakorn W, Yamwong S, et al. Long-term effects of socioeconomic status on incident hypertension and progression of blood pressure. J Hypertens. 2012;30(7):1347–53.CrossRefPubMed
13.
go back to reference Jo I, Ahn Y, Lee J, Shin KR, Lee HK, Shin C. Prevalence, awareness, treatment, control and risk factors of hypertension in Korea: the Ansan study. J Hypertens. 2001;19(9):1523–32.CrossRefPubMed Jo I, Ahn Y, Lee J, Shin KR, Lee HK, Shin C. Prevalence, awareness, treatment, control and risk factors of hypertension in Korea: the Ansan study. J Hypertens. 2001;19(9):1523–32.CrossRefPubMed
14.
go back to reference Choi KM, Park HS, Han JH, Lee JS, Lee J, Ryu OH, et al. Prevalence of prehypertension and hypertension in a Korean population: Korean National Health and Nutrition Survey 2001. J Hypertens. 2006;24(8):1515–21.CrossRefPubMed Choi KM, Park HS, Han JH, Lee JS, Lee J, Ryu OH, et al. Prevalence of prehypertension and hypertension in a Korean population: Korean National Health and Nutrition Survey 2001. J Hypertens. 2006;24(8):1515–21.CrossRefPubMed
15.
go back to reference Cha SH, Park HS, Cho HJ. Socioeconomic disparities in prevalence, treatment, and control of hypertension in middle-aged Koreans. J Epidemiol. 2012;22(5):425–32.CrossRefPubMedPubMedCentral Cha SH, Park HS, Cho HJ. Socioeconomic disparities in prevalence, treatment, and control of hypertension in middle-aged Koreans. J Epidemiol. 2012;22(5):425–32.CrossRefPubMedPubMedCentral
16.
go back to reference Weisell RC. Body mass index as an indicator of obesity. Asia Pac J Clin Nutr. 2002;11:S681–4.CrossRef Weisell RC. Body mass index as an indicator of obesity. Asia Pac J Clin Nutr. 2002;11:S681–4.CrossRef
17.
go back to reference Park HS, Park CY, Oh SW, Yoo HJ. Prevalence of obesity and metabolic syndrome in Korean adults. Obes Rev. 2008;9(2):104–7.CrossRefPubMed Park HS, Park CY, Oh SW, Yoo HJ. Prevalence of obesity and metabolic syndrome in Korean adults. Obes Rev. 2008;9(2):104–7.CrossRefPubMed
18.
go back to reference Kaplan MS, Huguet N, Feeny DH, McFarland BH. Self-reported hypertension prevalence and income among older adults in Canada and the United States. Soc Sci Med. 2010;70(6):844–9.CrossRefPubMed Kaplan MS, Huguet N, Feeny DH, McFarland BH. Self-reported hypertension prevalence and income among older adults in Canada and the United States. Soc Sci Med. 2010;70(6):844–9.CrossRefPubMed
19.
go back to reference Minh HV, Byass P, Chuc NT, Wall S. Gender differences in prevalence and socioeconomic determinants of hypertension: findings from the WHO STEPs survey in a rural community of Vietnam. J Hum Hypertens. 2006;20(2):109–15.CrossRefPubMed Minh HV, Byass P, Chuc NT, Wall S. Gender differences in prevalence and socioeconomic determinants of hypertension: findings from the WHO STEPs survey in a rural community of Vietnam. J Hum Hypertens. 2006;20(2):109–15.CrossRefPubMed
20.
go back to reference Barbeau EM, Krieger N, Soobader MJ. Working class matters: socioeconomic disadvantage, race/ethnicity, gender, and smoking in NHIS 2000. Am J Public Health. 2004;94(2):269–78.CrossRefPubMedPubMedCentral Barbeau EM, Krieger N, Soobader MJ. Working class matters: socioeconomic disadvantage, race/ethnicity, gender, and smoking in NHIS 2000. Am J Public Health. 2004;94(2):269–78.CrossRefPubMedPubMedCentral
21.
go back to reference Kaplan GA, Keil JE. Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation. 1993;88(4 Pt 1):1973–98.CrossRefPubMed Kaplan GA, Keil JE. Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation. 1993;88(4 Pt 1):1973–98.CrossRefPubMed
22.
go back to reference Park SH, Kim CH, Kim DJ, Suk KT, Park HY, Lee JG, et al. Secular trends in prevalence of alcohol use disorder and its correlates in Korean adults: results from Korea National Health and Nutrition Examination Survey 2005 and 2009. Subst Abus. 2012;33(4):327–35.CrossRefPubMed Park SH, Kim CH, Kim DJ, Suk KT, Park HY, Lee JG, et al. Secular trends in prevalence of alcohol use disorder and its correlates in Korean adults: results from Korea National Health and Nutrition Examination Survey 2005 and 2009. Subst Abus. 2012;33(4):327–35.CrossRefPubMed
23.
go back to reference Korea Centers for Disease Control and Prevention, Korea Health Statistics 2012, Korea National Health and Nutrition Examination Survey (KNHANESV-3), Seoul, Korea; Korean Ministry of Health and Welfare; 2013 Korea Centers for Disease Control and Prevention, Korea Health Statistics 2012, Korea National Health and Nutrition Examination Survey (KNHANESV-3), Seoul, Korea; Korean Ministry of Health and Welfare; 2013
24.
go back to reference Drewnowski A, Specter SE. Poverty and obesity: the role of energy density and energy costs. Am J Clin Nutr. 2004;79(1):6–16.PubMed Drewnowski A, Specter SE. Poverty and obesity: the role of energy density and energy costs. Am J Clin Nutr. 2004;79(1):6–16.PubMed
25.
go back to reference Hong SA, Kim K, Kim MK. Educational attainment and differences in fruit and vegetable consumption among middle-aged adults in the Korean National Health and Nutrition Examination Survey IV. Nutr Res Pract. 2012;6(3):263–9.CrossRefPubMedPubMedCentral Hong SA, Kim K, Kim MK. Educational attainment and differences in fruit and vegetable consumption among middle-aged adults in the Korean National Health and Nutrition Examination Survey IV. Nutr Res Pract. 2012;6(3):263–9.CrossRefPubMedPubMedCentral
Metadata
Title
Gender differences in the association between socioeconomic status and hypertension incidence: the Korean Genome and Epidemiology Study (KoGES)
Authors
Tae-Hwa Baek
Hae-Young Lee
Nam-Kyoo Lim
Hyun-Young Park
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2175-6

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