title: Income, education, and blood pressure in adults in Jamaica, a middle-income developing country.
abstract: BACKGROUND
  At present, little is known about how socioeconomic status (SES) is related to blood pressure (BP) and hypertension in developing countries. This cross-sectional study examined associations between SES and BP in 2082 adults from a peri-urban area of Jamaica, a middle-income developing country.
  
  
  METHODS
  Hypertension (systolic BP >/=140 mmHg, diastolic BP >/=90 mmHg or current hypertensive medication use) was estimated based on self-reported medication use and the mean of the second and third of three manual BP measurements. Income and education were self-reported. Linear or logistic regressions were used to estimate multivariate associations between BP or hypertension and SES.
  
  
  RESULTS
  Hypertension prevalence was 20% in men and 28% in women. In both men and women, the income distributions of BP and hypertension were non-linear, indicating elevated levels in low as well as in high-income groups. In contrast to the negative relationships typical for industrialized countries, multivariate-adjusted BP and hypertension were highest in the wealthiest women. In men with some high school education, income was positively associated with BP, while there were negative associations in men with lesser education. Unlike women, mean BP were highest in poor men with limited education. Low SES men were also least likely to receive diagnosis and treatment.
  
  
  CONCLUSIONS
  Socioeconomic status is related to BP and hypertension in Jamaica, although relationships are non-linear. Behavioural and environmental factors that explain elevated BP among both low and high SES adults in developing countries must be identified to develop effective prevention strategies.
authors.affiliation: Carolina Population Center, University of North Carolina at Chapel Hill, NC, USA.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Mendez
authors.forename: Richard
authors.initials: R
authors.lastname: Cooper
authors.forename: Rainford
authors.initials: R
authors.lastname: Wilks
authors.forename: Amy
authors.initials: A
authors.lastname: Luke
authors.forename: Terrence
authors.initials: T
authors.lastname: Forrester
mesh_terms: D000328:Adult; D000368:Aged; D003906:Developing Countries / Q000191:economics / Q000706:statistics & numerical data*; D004493:Education / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000628:therapy; D007182:Income; D007563:Jamaica / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012044:Regression Analysis; D017678:Sex Distribution