Root of socioeconomic impact on hypertension pinpointed

People who earn a low wage have a greater risk for hypertension than their counterparts with a higher income, especially women and those aged 25-44 years, research suggests.

J Paul Leigh (University of California Davis Medical School, USA) and Juan Dy (Old Dominion University, Norfolk, Virginia, USA) say their study suggests that wages specifically are a major contributing factor in the established association between low socioeconomic status and increased risk for developing hypertension.

"By isolating a direct and fundamental aspect of work that people greatly value, we were able to shed light on the relationship between socioeconomic status and circulatory health," commented Leigh in a press statement. "Wages are also a part of the employment environment that easily can be changed. Policymakers can raise the minimum wage, which tends to increase wages overall and could have significant public health benefits."

The analysis of 5651 household heads and their spouses over the three time periods 1999-2001, 2001-2003, and 2003-2005 was limited to working adults between 25-65 years of age. Anyone with hypertension during the first year of each time period was eliminated from the final sample (n=17,295).

As reported in the European Journal of Public Health, wages ranged from US$ 2.38 (€ 1.81) to US$ 77.00 (€ 58.40) per hour in 1999.

Logistic regression analysis revealed that risk for self-reported hypertension decreased by 16% with a doubling in wage. More specifically, for a given 2-year period, the risk for hypertension diagnosis was reduced by 1.2%, and by 0.6% over a 1-year period.

"This means that if there were 100 million persons employed in the USA between the ages of 25 and 65 per year during the entire timeframe of the study - from 1999 until 2005 - then a 10% increase in everyone's wages would have resulted in 132,000 fewer cases of hypertension each year," explained Leigh.

Further logistic regression analysis according to demographics such as age, gender, race, and comorbidities such as obesity, diabetes, and alcohol consumption revealed that the youngest individuals in the study (25-44 years) and women had the greatest risk for hypertension.

Indeed, doubling the wages of younger workers was associated with a 25-30% decrease in hypertension risk, while doubling the wages of women was associated with a 30-35% decreased risk.

"We were surprised that low wages were such a strong risk factor for two populations not typically associated with hypertension, which is more often linked with being older and male," remarked Leigh. "Our outcome shows that women and younger employees working at the lowest pay scales should be screened regularly for hypertension as well."

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