Ethnicity, education, and blood pressure in Cuba.
The causes of variation in hypertension risk by ethnicity and educational level are not well understood. To gain further insight into this issue in a nonindustrialized country, a population-based sample of 1,667 persons aged 15-74 years was recruited in Cienfuegos, Cuba. In this 2001-2002 study, interviewers classified 29% of participants as Black or mulatto and 71% as White. Educational attainment was stratified at the median number of school years. Compared with White women, non-White women had higher blood pressures (3.0/1.7, systolic blood pressure/diastolic blood pressure) and a higher prevalence of hypertension (24%, 95% confidence interval: 20, 28 vs. 15%, 95% confidence interval: 12, 18). Among men, no differences in blood pressure were observed by ethnicity. Men with a lower level of education had a 14% lower risk of hypertension compared with men above the median. However, women with a lower level of education had a 24% increase in risk. The effect of education was equally strong among Whites alone and when occupation was used for stratification. No variation was observed for body mass index or self-reported health behaviors by ethnicity or education. The narrower ethnic gradient in hypertension prevalence than seen in North America and the gender-specific social status effect, in the context of relatively equal living conditions, suggest that the influence of psychosocial stressors may be specific to cultural contexts.
Ordunez
Pedro
P
Department of Public Health, Faculty of Medical Sciences, University Hospital Dr. Gustavo Aldereguia Lima, Cienfuegos, Cuba.
Munoz
Jose Luis Bernal
JL
Espinosa-Brito
Alfredo
A
Silva
Luis Carlos
LC
Cooper
Richard S
RS
D000293:Adolescent; D000328:Adult; D000368:Aged; D044383:Black People / Q000193:education / Q000706:statistics & numerical data*; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D016001:Confidence Intervals; D003462:Cuba / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013315:Stress, Psychological / Q000150:complications / Q000208:ethnology; D044465:White People / Q000193:education / Q000706:statistics & numerical data*