Education across the life-course and hypertension in adults from Southern Brazil

The present study examines the association between life-course socioeconomic position (SEP) and hypertension (SAH), focusing on the health impacts of childhood SEP (SEPc), adult SEP (SEPa), as well as SEP mobility. Data from the Brazilian EpiFloripa Cohort Study (n = 1,720; 56% women; 55% <= 30 years) were analyzed. SAH was determined by the average of two measures of systolic and diastolic blood pressure, previous medical diagnosis or use of anti-hypertensive medication (43% of the sample was hypertensive). The main independent variables were: SEPa - participants' level of education; SEPc - parental educational attainment; and SEP mobility - the socio-economic trajectories from SEPc to SEPa. Five logistic regressions models were adjusted for sex, age or income, and were compared among each other. High SEPa was associated with a 37% reduction in the odds of SAH compared to low SEPa. High SEP over the life course was associated with 34-37% lower odds of SAH compared to persistent low SEP. Mobility models explained more of the outcome variance than the sensitive period model. The results reinforce the importance of education in the risk of SAH and the relevance of a socioeconomic mobility approach for the analysis of social inequalities in health.