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 and Mark Daniel
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Lisa A. Matricciani: 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
Catherine Paquet: 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
Natasha J. Howard: 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
Robert Adams: The Health Observatory, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia 5005, Australia
Neil T. Coffee: 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
Anne W. Taylor: Population Research and Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia 5005, Australia
Mark Daniel: 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

IJERPH, 2013, vol. 10, issue 2, 1-19

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: pulse pressure; socioeconomic status; residence characteristics; geographic information system; education; income; employment (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2013
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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