Abstract 18949: Socioeconomic Patterning of Hypertension in Grenada

Abstract

Over 80% of cardiovascular disease deaths occur in low and middle income countries with approximately two-thirds of stoke and one-half of ischemic heart disease estimated to be due to non-optimal blood pressure. Much is known about the social epidemiology of hypertension in “Western” contexts but less is known about these associations in developing or “non-Western” contexts. The island nation of Grenada, located off the Northeast coast of Venezuela with a population of approximately 110,000 persons, presents an instructive case study. This study describes the socioeconomic patterning of hypertension in a population of Grenadians. The Grenada Heart Project surveyed 2827 persons regarding the clinical, biological and psychosocial determinants of cardiovascular health between 2008 and 2010. We explored the association between education, income, occupation, nativity, residing in either the United States or Europe at one point in time, and parish of residence with definitive hypertension (≥140/90 mmHg) in separate logistic regression models adjusting for age and sex. The sample was 57.5% female with a mean age of 44.8 (sd = 17.1)., Participants that did not complete primary school [OR=2.04, 95%CI 1.37, 3.02)], participants that only completed primary school [OR=1.82, 95%CI 1.29, 2.58)], and participants that attended or completed secondary school [OR=1.48, 95%CI 0.99, 2.21)] had increased odds of having hypertension compared to those with more than a secondary education. Compared to government employees, homemakers [OR=2.45, 95%CI 1.52, 3.95)], retired persons [OR=2.40, 95%CI 1.69, 3.42)], and unemployed persons that are unable to work [OR=2.85, 95%CI 1.59, 5.11)] had increased odds of having hypertension whereas non-government employees [OR=1.09, 95%CI 0.79, 1.50)], self-employed persons [OR=1.09, 95%CI 0.96, 1.85)], and unemployed persons that are able to work [OR=1.09, 95%CI 0.68, 1.69)] did have significantly different odds of hypertension. We found significant differences in the prevalence of hypertension by parish. Income, nativity, and history of residing in western countries was not associated with hypertension. This work documents the importance of social variables in low and middle income countries in predicting hypertension.