Hypertension and perceived material insecurity in a disadvantaged Caribbean population

Philippe Carrère (1) , André Atallah (2) , Thierry Lang (3) , Benoît Lepage (4) , Jocelyn Inamo (5)

1 Département de médecine générale
2 Service de cardiologie
3 LEASP - Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps
4 Service Epidémiologie clinique et santé publique [CHU Toulouse]
5 Service de cardiologie

OBJECTIVE: To assess the relationship between hypertension and perceived material insecurity in a disadvantaged Caribbean population. PATIENTS AND METHODS: We used data from a cross-sectional study involving 2420 disadvantaged subjects aged 18-69 years, included consecutively at three Guadeloupian health centers. Hypertension was diagnosed over two consultations with a total of six blood pressure measurements. Perceived material insecurity was assessed using a closed-ended question. RESULTS: The prevalence of hypertension was estimated at 17.7% among subjects who believed their material situation would improve in the future, at 28.2% among those who believed it would remain the same, and at 43.3% among those who believed it would deteriorate. A multivariate logistic regression analysis showed that hypertension risk more than doubled (OR: 2.35 - P: 0.002) among subjects who believed that their material situation would deteriorate in the future compared to those who believed that their situation would improve, with no significant sex-related differences. This relationship was especially strong among subjects aged 40 years or more (OR: 3.30 - P<10(-3)), and among subjects with low education level (OR: 3.81 - P: 0.003), but was independent of the other tested variables. CONCLUSION: In this disadvantaged population, perceived material insecurity is a psychosocial factor strongly associated with hypertension, independently of subjects' risk behaviors. Subjects aged 40 years or more and subjects with a low education level seem the most vulnerable.

Mots clés: Hypertension; Cardiovascular; Psychosocial; Risk behaviors; Financial insecurity; Socioeconomic; Age; Adult; Disadvantage; Unemployed

Domaines: Santé publique et épidémiologie

Philippe Carrère, André Atallah, Thierry Lang, Benoît Lepage, Jocelyn Inamo. Hypertension and perceived material insecurity in a disadvantaged Caribbean population. Annales de Cardiologie et d'Angéiologie, 2012, 61 (3), pp.134-9. ⟨10.1016/j.ancard.2012.04.023⟩. ⟨hal-00739792⟩