[Hypertension and perceived material insecurity in a disadvantaged Caribbean population].
OBJECTIVE
To assess the relationship between hypertension and perceived material insecurity in a disadvantaged Caribbean population.


METHODS
We used data from a cross-sectional study involving 2420 disadvantaged subjects aged 18-69 years, included consecutively at three Guadeloupian health centers. Hypertension was diagnosed over two consultations with a total of six blood pressure measurements. Perceived material insecurity was assessed using a closed-ended question.


RESULTS
The prevalence of hypertension was estimated at 17.7% among subjects who believed their material situation would improve in the future, at 28.2% among those who believed it would remain the same, and at 43.3% among those who believed it would deteriorate. A multivariate logistic regression analysis showed that hypertension risk more than doubled (OR: 2.35 - P: 0.002) among subjects who believed that their material situation would deteriorate in the future compared to those who believed that their situation would improve, with no significant sex-related differences. This relationship was especially strong among subjects aged 40 years or more (OR: 3.30 - P<10(-3)), and among subjects with low education level (OR: 3.81 - P: 0.003), but was independent of the other tested variables.


CONCLUSIONS
In this disadvantaged population, perceived material insecurity is a psychosocial factor strongly associated with hypertension, independently of subjects' risk behaviors. Subjects aged 40 years or more and subjects with a low education level seem the most vulnerable.
Réseau HTA-GWAD, 10.01, résidence La Marina, Rivières-Sens, 97113 Gourbeyre, Guadeloupe. philippe.carrere@gmail.com
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Carrère
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Atallah
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Lepage
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Inamo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D017691:Caribbean Region / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003906:Developing Countries; D004522:Educational Status; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011203:Poverty; D015995:Prevalence; D012307:Risk Factors; D012938:Social Perception; D011795:Surveys and Questionnaires; D035862:Vulnerable Populations