Gender differences in the association between socioeconomic status and hypertension incidence: the Korean Genome and Epidemiology Study (KoGES).
BACKGROUND
Hypertension is a leading cause of cardiovascular events. We examined whether there was a gender difference in the association between SES, measured by education and income, and hypertension incidence.


METHODS
Data for 2596 men and 2686 women aged 40-69 years without hypertension at baseline from the Korean Genome and Epidemiology Study (KoGES) were analyzed. Participants had two follow-up examinations during 4 years, and were classified into three categories by self-reported educational attainment: ≥ 10 years, 7-9 years, and 0-6 years, and monthly household income (×10,000 Korean Won): ≥ 200, 100-199, and <100. The association between SES and incidence hypertension was examined by Cox's proportional hazard regression analyses.


RESULTS
Adjusting for conventional risk factors, compared with the high education group (reference), the hazard ratios (95% confidence interval) for incident hypertension across the education categories were 1.54 (1.16-2.06) and 1.80 (1.36-2.38) in women and 1.15 (0.92-1.43), and 1.08 (0.84-1.38) in men. Women with the low household income were more likely to have hypertension than those with the high household income and incident hypertension had an inverse association with household income level in women: multivariate adjusted hazard ratios were 1.00 (reference), 1.10 (0.83-1.45), and 1.63 (0.75-2.16). Men with medium income were less likely to have hypertension compared with those with high income (0.76, 0.61-0.90).


CONCLUSIONS
Educational level and economic status had stronger impacts on hypertension in Korean women than men. Thus, a stratified approach for women of low socioeconomic status, especially those with low educational attainment, is needed for the prevention of hypertension.
Division of Cardiovascular and Rare Disease, Center for Biomedical Science, Korea National Institute of Health, Cheongju, 187 OsongSaengmyeong2-Ro, Osong-Eup, Cheongju, Chungcheongbuk-Do, 361-951, Republic of Korea. taehwa.baek@gmail.com.
Tae-Hwa
TH
Baek
Department Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. hylee612@snu.ac.kr.
Hae-Young
HY
Lee
Division of Cardiovascular and Rare Disease, Center for Biomedical Science, Korea National Institute of Health, Cheongju, 187 OsongSaengmyeong2-Ro, Osong-Eup, Cheongju, Chungcheongbuk-Do, 361-951, Republic of Korea. namkyoo.lim@gmail.com.
Nam-Kyoo
NK
Lim
Division of Cardiovascular and Rare Disease, Center for Biomedical Science, Korea National Institute of Health, Cheongju, 187 OsongSaengmyeong2-Ro, Osong-Eup, Cheongju, Chungcheongbuk-Do, 361-951, Republic of Korea. mdhypark@gmail.com.
Hyun-Young
HY
Park
D000328:Adult; D044466:Asian People; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors