Incidence of hypertension and educational attainment - The NHANES I Epidemiologic Followup Study

Previous research has demonstrated the association between cardiovascular d isease and education. However, few studies have described the incidence of hypertension, a risk factor for cardiovascular disease, by education or oth er socioeconomic status indicators, To examine the association between hype rtension incidence and education, the authors analyzed data from the First National Health and Nutrition Examination Survey (NHANES I) Epidemiologic F ollowup Study (NHEFS) (1971-1984), The relative risk of hypertension incide nce (blood pressure greater than or equal to 160/95 and/or using antihypert ensive medication) by education was calculated for non-Hispanic Whites (age d 25-64 years) and non-Hispanic Blacks (aged 25-44 years) normotensive at b aseline using Cox proportional hazards models. The age-adjusted relative ri sk of hypertension incidence among persons with less than 12 years of educa tion compared with those with more than 12 years was significant among non- Hispanic Whites aged 25-44 years (men: relative risk (RR) = 2.14, 95% confi dence interval (Cl): 1.29, 3.54; women: RR = 2.06, 95% Cl: 1.39, 3.05) but not among non-Hispanic Blacks (RR = 1.16, 95% Cl: 0.63, 2.14). Relative ris ks for non-Hispanic White men remained stable after adjusting for age, syst olic blood pressure, body mass index, and region of residence; relative ris ks for non-Hispanic White women were reduced but remained significant. Non- Hispanic White men and women aged 45-64 years with less than 12 years of ed ucation were not at higher risk of developing hypertension compared with th eir more educated counterparts, These results demonstrate a significant int eraction between age and education with an independent association between education and hypertension incidence among younger but not older non-Hispan ic White men and women.