Educational level and hypertension: how socioeconomic differences condition health care

This is the first European study that has evaluated educational level in a large sample of hypertensive outpatients. We established the educational le vel of the hypertensive outpatients in our unit, and determined whether the awareness of hypertension and its organ damage was education-related. We a nalysed data from 812 consecutive outpatients (378 men, mean age 50 +/- 10 years) with essential stage I-II hypertension. Subjects were subdivided int o two categories: group A subjects were highly educated; group B subjects h ad a little education. Data were compared with educational level from the 1 991 population census for the Campania region (ISTAT data) and with 200 typ e 2 diabetes patients (96 men, mean age 51 +/- 9 years) from the nearest di abetes unit. For each hypertensive patient we considered clinical, echocard iographic and biochemical parameters. Data from the last census showed a hi gh percentage (80%) of subjects with low education. The percentage of type 2 diabetic patients with little education was high (190 patients, 95%). Con versely, it is somewhat surprising that most hypertensive patients reached high standards of education and worked at sedentary jobs (group A: 736 pati ents, 91%; P < 0.0001). Multivariate analysis showed that only diastolic bl ood pressure (P = 0.03) was indipendently associated with low educational l evel. Compared to diabetes, hypertension and its risk factors are relativel y unknown to people with little education. Education is associated with gre ater health care and awareness that may overcome the risk related to low ph ysical activity. Thus, we stress the importance of a sound health policy ab le to reach out to the uneducated and make them aware of hypertension and t he health care services available to them.