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. 2022 Jul 1;35(7):610-618.
doi: 10.1093/ajh/hpac051.

Ethnic Differences in the Prevalence of Hypertension in Colombia: Association With Education Level

Jose P Lopez-Lopez  1 , Daniel D Cohen  1 , Natalia Alarcon-Ariza  1 , Margarita Mogollon-Zehr  1 , Daniela Ney-Salazar  2 , Maria A Chacon-Manosalva  1 , Daniel Martinez-Bello  1 , Johanna Otero  1 , Gabriela Castillo-Lopez  3 , Maritza Perez-Mayorga  1   4 , Sumathy Rangarajan  5 , Salim Yusuf  5 , Patricio Lopez-Jaramillo  1   2
Affiliations

Ethnic Differences in the Prevalence of Hypertension in Colombia: Association With Education Level

Jose P Lopez-Lopez et al. Am J Hypertens. .

Abstract

Background: A higher prevalence of hypertension is reported among Afro-descendants compared with other ethnic groups in high-income countries; however, there is a paucity of information in low- and medium-income countries.

Methods: We evaluated 3,745 adults from 3 ethnic groups (552 White, 2,746 Mestizos, 447 Afro-descendants) enrolled in the prospective population-based cohort study (PURE)-Colombia. We assessed associations between anthropometric, socioeconomic, behavioral factors, and hypertension.

Results: The overall prevalence of hypertension was 39.2% and was higher in Afro-descendants (46.3%) than in Mestizos (37.6%) and Whites (41.5%), differences that were due to the higher prevalence in Afro-descendant women. Hypertension was associated with older age, increased body mass index, waist circumference and waist-to-hip ratio, independent of ethnicity. Low education was associated with hypertension in all ethnic groups, and particularly in Afro-descendants, for whom it was the factor with the strongest association with prevalence. Notably, 70% of Afro-descendants had a low level of education, compared with 52% of Whites-26% of Whites were university graduates while only 7% of Afro-descendants were. We did not find that education level alone had a mediator effect, suggesting that it is not a causal risk factor for hypertension but is an indicator of socioeconomic status, itself an important determinant of hypertension prevalence.

Conclusions: We found that a higher prevalence of hypertension in Colombian Afro-descendants than other ethnic groups. This was principally associated with their lower mean educational level, an indicator of lower socioeconomic status.

Keywords: Colombia; education level; ethnicity; hand grip strength; hypertension.

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Graphical Abstract
Graphical Abstract
Figure 1.
Figure 1.
Prevalence of hypertension among the ethnic groups: Mestizo, White, and Afro-descendent categorized by sex.
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