title: Explaining socioeconomic inequalities in childhood blood pressure and prehypertension: the ABCD study.
abstract: Much remains to be understood about the socioeconomic inequalities in hypertension that continue to exist. We investigated the association of socioeconomic status with blood pressure and prehypertension in childhood. In a prospective cohort, 3024 five- to six-year-old children had blood pressure measurements and available information on potential explanatory factors, namely birth weight, gestational age, smoking during pregnancy, pregnancy-induced hypertension, familial hypertension, maternal body mass index, breastfeeding duration, domestic tobacco exposure, and body mass index. The systolic and diastolic blood pressures of children from mid-educated women were 1.0-mm Hg higher (95% CI, 0.4-1.7) and 0.9-mm Hg higher (95% CI, 0.3-1.4), and the blood pressures of children with low-educated women were 2.2-mm Hg higher (95% CI, 1.4-3.0) and 1.7-mm Hg higher (95% CI, 1.1-2.4) compared with children with high-educated women. Children with mid- (odds ratio, 1.50; 95% CI, 1.18-1.92) or low-educated mothers (odds ratio, 1.80; 95% CI, 1.35-2.42) were more likely to have prehypertension compared with children with high-educated mothers. Using path analyses, birth weight, breastfeeding duration, and body mass index were determined as having a role in the association of maternal education with offspring blood pressure and prehypertension. The socioeconomic gradient in hypertension appears to emerge from childhood as the results show a higher blood pressure and more prehypertension in children from lower socioeconomic status families. Socioeconomic disparities could be reduced by improving 3 factors in particular, namely birth weight, breastfeeding duration, and body mass index, but other factors might also play a role.
authors.affiliation: Department of Pediatrics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands. g.vandenberg@vumc.nl
authors.forename: Gerrit
authors.initials: G
authors.lastname: van den Berg
authors.forename: Manon
authors.initials: M
authors.lastname: van Eijsden
authors.forename: Francisca
authors.initials: F
authors.lastname: Galindo-Garre
authors.forename: Tanja G M
authors.initials: TG
authors.lastname: Vrijkotte
authors.forename: Reinoud J B J
authors.initials: RJ
authors.lastname: Gemke
mesh_terms: D001724:Birth Weight / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D001942:Breast Feeding; D002648:Child; D002675:Child, Preschool; D004522:Educational Status; D005260:Female; D005865:Gestational Age; D006801:Humans; D008297:Male; D011247:Pregnancy; D058246:Prehypertension / Q000209:etiology* / Q000503:physiopathology; D011446:Prospective Studies; D012907:Smoking; D012923:Social Class; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires