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. 2024 Mar 12;14(3):e076785.
doi: 10.1136/bmjopen-2023-076785.

Association between socioeconomic status and hypertension among adults in Fujian province and the mediating effect of BMI and cooking salt intake: a cross-sectional study

Yuqing Li #  1   2 , Wailiang Ge #  1 , Minxia Wu  3 , Mengyang Gao  1 , Zhongrui Peng  1 , Yaofeng Han  1 , Xiangju Hu  4 , Lei Li  5
Affiliations

Association between socioeconomic status and hypertension among adults in Fujian province and the mediating effect of BMI and cooking salt intake: a cross-sectional study

Yuqing Li et al. BMJ Open. .

Abstract

Objectives: This study aimed to investigate the association between socioeconomic status (SES) and the prevalence of hypertension in Fujian province, China, and to evaluate the mediating effect of body mass index (BMI) and cooking salt intake between SES and hypertension.

Design: Community-based cross-sectional survey was conducted between June 2018 and December 2019.

Setting: Fujian province, China.

Participants: A total of 26 500 participants aged >18 years completed the survey.

Outcome measures: The primary outcome was the prevalence of hypertension. Education, income and occupation were used as SES indicators. Meanwhile, certain health behaviours and metabolic risk factors were used as secondary indicators of SES.

Results: The prevalence of hypertension was relatively high among participants who finished primary education (34.8%), had the lowest annual income (46.0%), were unemployed or retired (34.7%). Education and income levels were negatively associated with the prevalence of hypertension (p<0.05). Regular smoking, alcohol consumption, BMI and high cooking salt intake were also significantly associated with the prevalence of hypertension (p<0.05). Cooking salt intake was identified as a partial mediator between income and hypertension, mediating 3.45% of the association. Both BMI and cooking salt intake were partial mediators between education and hypertension, mediating 5.23% and 1.93% of the association, respectively.

Conclusions: SES was associated with the prevalence of hypertension among adults in Fujian province, China. BMI and cooking salt intake were partial mediators of the association between SES and hypertension.

Keywords: epidemiologic studies; factor analysis, statistical; hypertension; public health.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
The mediating effect of body mass index (BMI) and cooking salt intake on the association between income/education and hypertension. (A) The mediating effect of cooking salt intake on the association between income and hypertension. (B) The mediating effect of BMI and cooking salt intake on the association between education and hypertension (multiple mediator model). a, effect of X on M; b, effect of M on Y controlling for the effect of X; c’, direct effect of X on Y; c, total effect of X on Y (sum of the indirect effect and direct effect; c=a×b+c’). *p<0.05, **p<0.01.
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