Risks of socioeconomic deprivation on mortality in hypertensive patients

Objective To determine if the increased risk of cardiovascular disease in patients with lower socioeconomic status could be explained by higher prevalence of known risk factors including hypertension or whether there was an independent effect of deprivation. Methods A retrospective cohort study of mortality was carried out on 3360 patients who attended Glasgow Blood Pressure Unit between 1991 and 2000, followed for a mean period of 8.1 years. Cox proportional hazards models were used to adjust for the effects of age, sex, socioeconomic circumstances, systolic and diastolic blood pressures at baseline and on treatment, smoking, diabetes mellitus, history of angina and myocardial infarction, excessive alcohol consumption, BMI and serum cholesterol. Results Of 442 deaths, 244 (55%) were from cardiovascular diseases. After adjustment, residents of the most deprived areas had a hazard ratio for all cause mortality of 1.46 (95% confidence interval 1.04, 2.04). Adjusted hazard ratio for death from cardiovascular disease in the most deprived areas was 1.65 (1.04, 2.60) compared with those from the most affluent areas. Conclusion Socioeconomic deprivation appears to have a significant independent effect on risks of death from cardiovascular disease. J Hypertens 27:730-735 (C) 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins.