Hypertension and social factors in a developing country

A coronary heart disease prevention study, implemented in and near Havana (Cuba), evaluated the correlation of social factors with major cardiovascular risk factors, including elevations in blood pressure, in order to improve treatment strategies and compliance. The protocol consisted of questionnaires, standardized measurements of blood pressure and cholesterol determination at a central laboratory. The assessment of social aspects was carried out as previously described in comparable preventive studies in the German Democratic Republic. Around 1200 people aged 30-50 years had been screened by home visits. Correlations were found between blood pressure elevation (as well as smoking and hypercholesterolaemia, at least in part) and education, but in the opposite direction compared with experience in the United States and Europe. The prevalence of hypertension (and mean blood pressure) was higher in qualified than unqualified people (especially in younger males). Sex was a more important factor than age. No conclusion can be drawn from the variations between urban and rural subjects because the observations were not complete.