gms | German Medical Science

Objective: A lower socio-economic status (SES) is believed to be a risk factor for high blood pressure. We investigated the effect of SES on the prevalences on elevated blood pressure. Data from GEMCAS a nation wide cross sectional study in Germany with 35,869 subjects were analyzed.

Design and Method: Blood pressure was classified to normal and high (≥140/≥90 mmHg). SES was defined basing on the number of years of education as low (<10years), medium (=10), high (>10). Body Mass Index (BMI) class was defined as normal (18<BMI≤29.99) and obese (30≤BMI). Prevalence odds ratios (PORs) and 95%-confidence-intervalls (95%-CI) for hypertension and SES were computed adjusting for age.

Results: Prevalence of normal and high blood pressures were both 50% in men and women with lowest SES, whereas only 25% women and 42% men in the highest SES had high blood pressure. Smoking was most prevalent in the lowest SES (36% men, 21% women vs. highest SES: 21% men, 19% women). In the lowest SES obesity was found in 32% men (35% women), medium SES 28% men (23% women), and in the highest SES 20% men (15% women). Men and women of lower SES when compared to higher SES were at more risk to show hypertension with PORs of 1.24 (95%-CI 1.09-1.40) and 3.01 (2.75-3.28) respectively (medium SES men: 1.20 (1.12-1.29), women: 1.54 (1.43-1.66)). When stratified for BMI the age-adjusted POR for men with BMI <30 was 1.17 (0.95-1.30), women 1.58 (1.41-1.78), however the SES is not associated with an elevated blood pressure in those with a BMI >=30 (men: 0.93 (0.73-1.18) women 1.05 (0.87- 1.27))

Conclusion: In this study less then 10 years of education is associated with an elevated blood pressure only in women, which seems to be especially important in women with a BMI <30.