Do the socioeconomic and hypertension gradients in rural populations of low- and middle-income countries differ by geographical region? A systematic review and meta-analysis

Busingye, Doreen, Arabshahi, Simin, Subasinghe, Asvini K., Evans, Roger G., Riddell, Michaela A. and Thrift, Amanda G. (2014) Do the socioeconomic and hypertension gradients in rural populations of low- and middle-income countries differ by geographical region? A systematic review and meta-analysis. International Journal of Epidemiology, 43 5: 1563-1577. doi:10.1093/ije/dyu112


Author Busingye, Doreen
Arabshahi, Simin
Subasinghe, Asvini K.
Evans, Roger G.
Riddell, Michaela A.
Thrift, Amanda G.
Title Do the socioeconomic and hypertension gradients in rural populations of low- and middle-income countries differ by geographical region? A systematic review and meta-analysis
Journal name International Journal of Epidemiology   Check publisher's open access policy
ISSN 0300-5771
1464-3685
Publication date 2014-10-01
Year available 2014
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1093/ije/dyu112
Open Access Status Not Open Access
Volume 43
Issue 5
Start page 1563
End page 1577
Total pages 15
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Language eng
Formatted abstract
Background: Of the 1 billion people with hypertension globally, two-thirds reside in low- and middle-income countries (LMICs). The risk of hypertension in LMICs is thought to be positively associated with socioeconomic status (SES). However, recent studies have provided data inconsistent with this concept. Thus, we assessed the association between SES and hypertension in rural populations of LMICs. Further, we explored whether this association differs according to geographical region.

Methods: Through a search of databases we identified population-based studies that presented risk estimates for the association between SES, or any of its proxies, and hypertension. Meta-analyses were conducted using a random effects model.

Results: Overall, no association was detected between educational status and hypertension, whereas a positive association was observed with income. Interestingly, educational status was inversely associated with hypertension in East Asia {effect size [ES] 0.82 [95% confidence interval (CI) 0.78, 0.87]} but positively associated in South Asia [ES 1.28 (95% CI 1.14, 1.43)]. Higher income, household assets or social class were positively associated with hypertension in South Asia whereas no association was detected in East Asia and Africa. Compared with other occupations, farmers or manual labourers were associated with a lower risk for hypertension. Further, in regions such as Latin America, few studies were identified that fulfilled our inclusion criteria.

Conclusions: We provide evidence that the association between hypertension and SES in rural populations of LMICs in Asia varies according to geographical region. This has important implications for targeting intervention strategies aimed at high-risk populations in different geographical regions.
Keyword Hypertension
Socioeconomic status
Income
Educational Status
Occupation
Low and middle income countries
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collection: School of Public Health Publications
 
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Created: Wed, 11 Nov 2015, 00:13:26 EST by Simin Arabshahi on behalf of School of Public Health