TY - JOUR
T1 - Sex Difference and Socioeconomic Inequity in Chinese People With Hypertension
T2 - National Cross-Sectional Survey Study
AU - Zhang, Xiaoyun
AU - Wang, Siyu
AU - Yang, Qianqian
AU - Zheng, Ruizhi
AU - Wang, Long
AU - Lin, Hong
AU - Wang, Shuangyuan
AU - Li, Mian
AU - Wang, Tiange
AU - Zhao, Zhiyun
AU - Lu, Jieli
AU - Xu, Min
AU - Chen, Yuhong
AU - Zheng, Jie
AU - Dai, Meng
AU - Zhang, Di
AU - Wang, Weiqing
AU - Ning, Guang
AU - Bi, Yufang
AU - Xu, Yu
N1 - Publisher Copyright:
© Xiaoyun Zhang, Siyu Wang, Qianqian Yang, Ruizhi Zheng, Long Wang, Hong Lin, Shuangyuan Wang, Mian Li, Tiange Wang, Zhiyun Zhao, Jieli Lu, Min Xu, Yuhong Chen, Jie Zheng, Meng Dai, Di Zhang, Weiqing Wang, Guang Ning, Yufang Bi, Yu Xu.
PY - 2024
Y1 - 2024
N2 - Background: Sex differences in blood pressure (BP) levels and hypertension are important and the role of socioeconomic status (SES) in sex differences in hypertension remains unclear. Objective: This study aimed to evaluate the impact of SES on sex differences of hypertension in a nationally representative survey study. Methods: A total of 98,658 participants aged ≥18 years who have lived in their current residence for ≥6 months were recruited from 162 study sites across mainland China. Sex was self-reported. Individual-level SES included the highest level of education and annual household income. Area-level SES included economic development status, urban/rural residency, and north/south location. Outcomes included levels of systolic and diastolic BP, and hypertension. Linear and Cox regression models were used to examine the associations between sex (women vs men) and BP characteristics stratified by individual or combined SES indicators. Results: Systolic and diastolic BP levels and the prevalence of hypertension were higher in men than in women. This sex difference was found across categories of SES with widened sex disparities in participants having more favorable SES. Significant multiplicative interaction effects of SES on the association of sex with BP characteristics were found. Women with improving SES were associated with lower BP and hypertension prevalence compared to men. For combined SES, a 9% (prevalence ratio 0.91, 95% CI 0.83-0.98) and a 30% lower probability (prevalence ratio 0.70, 95% CI 0.63-0.78) of having hypertension were found in women with an overall intermediate SES and high SES, respectively, compared to those with low SES, while no significant reduction was found in men. Conclusions: There are significant sex differences in BP characteristics and SES has a potent impact on the disparities. Sex-specific public health policies to alleviate socioeconomic inequalities, especially in women are important for the prevention of hypertension.
AB - Background: Sex differences in blood pressure (BP) levels and hypertension are important and the role of socioeconomic status (SES) in sex differences in hypertension remains unclear. Objective: This study aimed to evaluate the impact of SES on sex differences of hypertension in a nationally representative survey study. Methods: A total of 98,658 participants aged ≥18 years who have lived in their current residence for ≥6 months were recruited from 162 study sites across mainland China. Sex was self-reported. Individual-level SES included the highest level of education and annual household income. Area-level SES included economic development status, urban/rural residency, and north/south location. Outcomes included levels of systolic and diastolic BP, and hypertension. Linear and Cox regression models were used to examine the associations between sex (women vs men) and BP characteristics stratified by individual or combined SES indicators. Results: Systolic and diastolic BP levels and the prevalence of hypertension were higher in men than in women. This sex difference was found across categories of SES with widened sex disparities in participants having more favorable SES. Significant multiplicative interaction effects of SES on the association of sex with BP characteristics were found. Women with improving SES were associated with lower BP and hypertension prevalence compared to men. For combined SES, a 9% (prevalence ratio 0.91, 95% CI 0.83-0.98) and a 30% lower probability (prevalence ratio 0.70, 95% CI 0.63-0.78) of having hypertension were found in women with an overall intermediate SES and high SES, respectively, compared to those with low SES, while no significant reduction was found in men. Conclusions: There are significant sex differences in BP characteristics and SES has a potent impact on the disparities. Sex-specific public health policies to alleviate socioeconomic inequalities, especially in women are important for the prevention of hypertension.
UR - https://www.scopus.com/pages/publications/85211421213
U2 - 10.2196/63144
DO - 10.2196/63144
M3 - Article
C2 - 39621934
AN - SCOPUS:85211421213
SN - 2369-2960
VL - 10
JO - JMIR Public Health and Surveillance
JF - JMIR Public Health and Surveillance
M1 - e63144
ER -