Investigating individual- and area-level socioeconomic gradients of pulse pressure among normotensive and hypertensive participants

Lisa A Matricciani; Catherine Paquet; Natasha J. Howard; Robert Adams; Neil T. Coffee; Anne W. Taylor; Mark Daniel

doi:10.3390/ijerph10020571

Investigating individual- and area-level socioeconomic gradients of pulse pressure among normotensive and hypertensive participants

Lisa A Matricciani, Catherine Paquet, Natasha J. Howard, Robert Adams, Neil T. Coffee, Anne W. Taylor, Mark Daniel

Flinders University

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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.

Original language	English
Pages (from-to)	571-589
Number of pages	19
Journal	International Journal of Environmental Research and Public Health
Volume	10
Issue number	2
DOIs	https://doi.org/10.3390/ijerph10020571
Publication status	Published - 4 Feb 2013

Bibliographical note

© 2013 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article
distributed under the terms and conditions of the Creative Commons Attribution license
(http://creativecommons.org/licenses/by/3.0/).

Keywords

Cardiovascular disease
hypertension
Sociodemographic determinants
Residence characteristics
Socioeconomic status
Education
Employment
Geographic information system
Income
Pulse pressure

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3390/ijerph10020571Licence: CC BY

Matricciani_Investigating_P2013Final published version, 207 KBLicence: CC BY

Cite this

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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.",

keywords = "Cardiovascular disease, hypertension, Sociodemographic determinants, Residence characteristics, Socioeconomic status, Education, Employment, Geographic information system, Income, Pulse pressure",

author = "Matricciani, {Lisa A} and Catherine Paquet and Howard, {Natasha J.} and Robert Adams and Coffee, {Neil T.} and Taylor, {Anne W.} and Mark Daniel",

note = "{\textcopyright} 2013 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/).",

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Investigating individual- and area-level socioeconomic gradients of pulse pressure among normotensive and hypertensive participants. / Matricciani, Lisa A; Paquet, Catherine; Howard, Natasha J. et al.
In: International Journal of Environmental Research and Public Health, Vol. 10, No. 2, 04.02.2013, p. 571-589.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Investigating individual- and area-level socioeconomic gradients of pulse pressure among normotensive and hypertensive participants

AU - Matricciani, Lisa A

AU - Paquet, Catherine

AU - Howard, Natasha J.

AU - Adams, Robert

AU - Coffee, Neil T.

AU - Taylor, Anne W.

AU - Daniel, Mark

N1 - © 2013 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/).

PY - 2013/2/4

Y1 - 2013/2/4

N2 - 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.

AB - 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.

KW - Cardiovascular disease

KW - hypertension

KW - Sociodemographic determinants

KW - Residence characteristics

KW - Socioeconomic status

KW - Education

KW - Employment

KW - Geographic information system

KW - Income

KW - Pulse pressure

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U2 - 10.3390/ijerph10020571

DO - 10.3390/ijerph10020571

M3 - Article

SN - 1660-4601

VL - 10

SP - 571

EP - 589

JO - International Journal of Environmental Research and Public Health

JF - International Journal of Environmental Research and Public Health

IS - 2

ER -

Investigating individual- and area-level socioeconomic gradients of pulse pressure among normotensive and hypertensive participants

Abstract

Bibliographical note

Keywords

UN SDGs

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