Ethnicity, education, and blood pressure in Cuba

Am J Epidemiol. 2005 Jul 1;162(1):49-56. doi: 10.1093/aje/kwi163.

Abstract

The causes of variation in hypertension risk by ethnicity and educational level are not well understood. To gain further insight into this issue in a nonindustrialized country, a population-based sample of 1,667 persons aged 15-74 years was recruited in Cienfuegos, Cuba. In this 2001-2002 study, interviewers classified 29% of participants as Black or mulatto and 71% as White. Educational attainment was stratified at the median number of school years. Compared with White women, non-White women had higher blood pressures (3.0/1.7, systolic blood pressure/diastolic blood pressure) and a higher prevalence of hypertension (24%, 95% confidence interval: 20, 28 vs. 15%, 95% confidence interval: 12, 18). Among men, no differences in blood pressure were observed by ethnicity. Men with a lower level of education had a 14% lower risk of hypertension compared with men above the median. However, women with a lower level of education had a 24% increase in risk. The effect of education was equally strong among Whites alone and when occupation was used for stratification. No variation was observed for body mass index or self-reported health behaviors by ethnicity or education. The narrower ethnic gradient in hypertension prevalence than seen in North America and the gender-specific social status effect, in the context of relatively equal living conditions, suggest that the influence of psychosocial stressors may be specific to cultural contexts.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Black People / education
  • Black People / statistics & numerical data*
  • Blood Pressure / physiology*
  • Body Mass Index
  • Confidence Intervals
  • Cuba / epidemiology
  • Educational Status*
  • Female
  • Humans
  • Hypertension / epidemiology
  • Hypertension / ethnology*
  • Hypertension / psychology
  • Male
  • Middle Aged
  • Prevalence
  • Stress, Psychological / complications
  • Stress, Psychological / ethnology
  • White People / education
  • White People / statistics & numerical data*