The association of educational attainment and SBP among older community-living adults:  the Maintenance of Balance, Independent Living, Intellect and Zest in the Elderly (MOBILIZE) Boston Study.
OBJECTIVE
Educational attainment is inversely associated with SBP level in young adulthood. This association has not been studied in an older cohort, and confounding and mediating factors are not well known.


METHODS
The authors hypothesized that higher education is associated with lower levels of SBP independent of many risk factors for hypertension. This prospective observational study included a sample of 764 older community-living participants in the Maintenance of Balance, Independent Living, Intellect and Zest in the Elderly (MOBILIZE) Boston Study.


RESULTS
Compared to participants with more than college education, regression analyses showed those with a high school education or less had a SBP value 6.33 mmHg higher [95% confidence interval (CI): 2.55-10.10], and those who had a college education had a SBP value 4.01 mmHg higher (95% CI: 0.77-7.25) independent of many hypothesized confounders and mediators.


CONCLUSIONS
Results of a path analysis confirmed that higher level of education was associated with lower SBP even after adjustment for hypothesized mediators. Although slightly attenuated by multivariable adjustment for hypertension risk factors, the significant inverse association between educational attainment and SBP was not entirely mediated by these risk factors. These findings indicate that education is inversely associated with SBP in a diverse cohort of community-living older adults, independent of many known or suspected risk factors.


CONCLUSIONS
This study is the first to report the association between education and SBP in an older sample, representing a population at the highest risk for hypertension-related morbidity and mortality.
Institute for Aging Research, Hebrew Senior Life, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02131, USA. kiely@hsl.harvard.edu
Dan K
DK
Kiely
Alden L
AL
Gross
Dae H
DH
Kim
Lewis A
LA
Lipsitz
D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D001900:Boston / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D057187:Independent Living; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D012111:Residence Characteristics; D012307:Risk Factors