title: Investigating individual- and area-level socioeconomic gradients of pulse pressure among normotensive and hypertensive participants.
abstract: Socioeconomic status is a strong predictor of cardiovascular disease. Pulse pressure, the difference between systolic and diastolic blood pressure, has been identified as an important predictor of cardiovascular risk even after accounting for absolute measures of blood pressure. However, little is known about the social determinants of pulse pressure. The aim of this study was to examine individual- and area-level socioeconomic gradients of pulse pressure in a sample of 2,789 Australian adults. Using data from the North West Adelaide Health Study we estimated the association between pulse pressure and three indices of socioeconomic status (education, income and employment status) at the area and individual level for hypertensive and normotensive participants, using Generalized Estimating Equations. In normotensive individuals, area-level education (estimate: -0.106; 95% CI: -0.172, -0.041) and individual-level income (estimate: -1.204; 95% CI: -2.357, -0.050) and employment status (estimate: -1.971; 95% CI: -2.894, -1.048) were significant predictors of pulse pressure, even after accounting for the use of medication and lifestyle behaviors. In hypertensive individuals, only individual-level measures of socioeconomic status were significant predictors of pulse pressure (education estimate: -2.618; 95% CI: -4.878, -0.357; income estimate: -1.683, 95% CI: -3.743, 0.377; employment estimate: -2.023; 95% CI: -3.721, -0.326). Further research is needed to better understand how individual- and area-level socioeconomic status influences pulse pressure in normotensive and hypertensive individuals.
authors: Social Epidemiology and Evaluation Research Group, Sansom Institute for Health Research, School of Population Health, Division of Health Sciences, University of South Australia, Adelaide 5001, Australia.
authors: Lisa A
authors: LA
authors: Matricciani
authors: Catherine
authors: C
authors: Paquet
authors: Natasha J
authors: NJ
authors: Howard
authors: Robert
authors: R
authors: Adams
authors: Neil T
authors: NT
authors: Coffee
authors: Anne W
authors: AW
authors: Taylor
authors: Mark
authors: M
authors: Daniel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors; D013021:South Australia / Q000453:epidemiology; D055815:Young Adult
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