Social disparities in pre-hypertension and hypertension in colombian adults

Background: Hypertension is the main risk factor for cardiovascular disease (CVD), the leading cause of death in Colombia. Research on hypertension in Colombia has traditionally focused on proximal risk factors; studies on prehypertension, an independent risk for CVD, are almost absent; and the social patterning of both pre-hypertension and hypertension has been little examined. This research offered a unique opportunity to: 1) examine ethnic/race and socioeconomic disparities in pre-hypertension and hypertension; and 2) examine variations in the magnitude and direction of the effect of indicators of socioeconomic position on pre-hypertension and hypertension.

Data and Methods. Data came from the Colombian National Survey of Health 2007, a nationally representative sample of the Colombian population. Sequential multinomial logistic regression models were fitted with normotensive, prehypertension and hypertension as dependent variables.

Results & Implications. Except for hypertension in black women, ethnicity/race was not a significant predictor for either pre-hypertension or hypertension. Indigenous populations did not have a lower risk of pre-hypertension or hypertension than mixed population. Education behaved in the expected direction (higher education, lower risk of pre-hypertension and hypertension). Renters had a lower risk of pre-hypertension or hypertension than owners. Markers of material resources and bio-behavioral risk factors partially mediated the association between education and pre-hypertension and hypertension in women.

Interventions for the prevention of pre-hypertension and hypertension in Colombia are likely to have limited impacts if they do not address fundamental causes of health. Interventions that improve educational levels offer some promise in reducing rates of pre-hypertension and hypertension in Colombia.