title: Family socioeconomic factors are negatively associated with blood pressure in European boys, but not girls, and Brazilian adolescents: Results from two observational studies.
abstract: OBJECTIVE
  We aimed to estimate the attributable fraction of systolic (SBP) and diastolic blood pressure (DBP) that can be explained by family socioeconomic factors (FSFs) in adolescents using two observational studies.
  
  
  METHODS
  Participants were recruited by multistage random cluster in two cross-sectional studies performed in Europe [Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, n = 3308] and Brazil [Brazilian Cardiovascular Adolescent Health (BRACAH) study, n = 991]. SBP and DBP were measured, and FSFs (socioeconomic status and parental education) were self-reported in both studies. The correlations of SBP and DBP with FSFs were examined by multilevel linear regression through two different models (hierarchical and fully adjusted). The generalized attributable fractions of the FSFs were estimated by comparing the models.
  
  
  RESULTS
  Our results showed a significant inverse relationship between parental education (father and mother) and SBP in European boys. The higher generalized attributable fraction to SBP was observed in boys (13.2-22.4%). In girls, we found lower generalized attributable fractions to DBP (10.8-12.1% in Brazilian girls and 3.1-3.8% in European girls).
  
  
  CONCLUSIONS
  Our findings revealed a significant inverse relationship between parental education and SBP in European boys. FSF also significantly influenced blood pressure in adolescents, mainly in Brazilian adolescents.
authors.affiliation: YCARE (Youth/Child and cARdiovascular Risk and Environmental) Research Group, Department of Preventive Medicine, School of Medicine of the University of São Paulo , São Paulo, SP , Brazil.
authors.forename: Augusto César Ferreira
authors.initials: AC
authors.lastname: de Moraes
authors.forename: Heráclito Barbosa
authors.initials: HB
authors.lastname: Carvalho
authors.forename: Sonia
authors.initials: S
authors.lastname: Gomez-Martinez
authors.forename: Odysseas
authors.initials: O
authors.lastname: Androutsos
authors.forename: David
authors.initials: D
authors.lastname: Jiménez-Pavón
authors.forename: Michael
authors.initials: M
authors.lastname: Sjöström
authors.forename: Anthony
authors.initials: A
authors.lastname: Kafatos
authors.forename: Kurt
authors.initials: K
authors.lastname: Widhalm
authors.forename: David
authors.initials: D
authors.lastname: Cañada
authors.forename: Miguel
authors.initials: M
authors.lastname: Martin-Matillas
authors.forename: Laurent
authors.initials: L
authors.lastname: Beghin
authors.forename: Frederic
authors.initials: F
authors.lastname: Gottrand
authors.forename: Luis A
authors.initials: LA
authors.lastname: Moreno
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology*; D001938:Brazil; D002648:Child; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Adolescents; blood pressure; epidemiology; multilevel modeling; social factors