Contribution of early and adult factors to socioeconomic variation in blood pressure: thirty-four-year follow-up study of school children.
OBJECTIVE
To prospectively examine the role of childhood and adulthood factors in the association between socioeconomic status (SES) and adult systolic and diastolic blood pressure (SBP, DBP).


METHODS
One hundred and five boys and 101 girls who were 8 years of age at entry into the study were observed for 34 years in the Jyväskylä Longitudinal Study of Personality and Social Development, Finland. Data were gathered on educational attainment and occupational status, as indicators of SES, and potential explanatory factors related to 0, (14), 27, 36, and 42 years of age. SBP and DBP were assessed at 15 and 42 years of age.


RESULTS
In a structural equation model adjusted for sex and childhood SBP, educational attainment was inversely associated with adult SBP (structural coefficient -0.17, p<.05). Incorporating the effects of parental SES and adult body mass index into the model attenuated this association so that it was no longer significant. Variation in birth weight, unemployment, smoking, alcohol consumption, and use of antihypertensive medication had marginal or no impact on the education-SBP association. No socioeconomic variation was found for DBP or occupational status.


CONCLUSIONS
Prospective evidence suggests a weak association between low educational attainment and development of high SBP. Parental SES and adult BMI were the key explanatory factors for this association.
Kivimäki
Mika
M
University of Helsinki, Helsinki, Finland. mika.kivimaki@ttl.fi
Kinnunen
Marja-Liisa
ML
Pitkänen
Tuuli
T
Vahtera
Jussi
J
Elovainio
Marko
M
Pulkkinen
Lea
L
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D002648:Child; D004522:Educational Status; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology; D008137:Longitudinal Studies; D008297:Male; D010290:Parents; D011446:Prospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D012923:Social Class