Family socioeconomic factors are negatively associated with blood pressure in European boys, but not girls, and Brazilian adolescents: Results from two observational studies

Abstract

Objective. We aimed to estimate the attributable fraction of systolic (SBP) and diastolic blood pressure (DBP) that can be explained by family socioeconomic factors (FSFs) in adolescents using two observational studies. Methods. Participants were recruited by multistage random cluster in two cross-sectional studies performed in Europe [Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, n = 3308] and Brazil [Brazilian Cardiovascular Adolescent Health (BRACAH) study, n = 991]. SBP and DBP were measured, and FSFs (socioeconomic status and parental education) were self-reported in both studies. The correlations of SBP and DBP with FSFs were examined by multilevel linear regression through two different models (hierarchical and fully adjusted). The generalized attributable fractions of the FSFs were estimated by comparing the models. Results. Our results showed a significant inverse relationship between parental education (father and mother) and SBP in European boys. The higher generalized attributable fraction to SBP was observed in boys (13.2–22.4%). In girls, we found lower generalized attributable fractions to DBP (10.8–12.1% in Brazilian girls and 3.1–3.8% in European girls). Conclusions. Our findings revealed a significant inverse relationship between parental education and SBP in European boys. FSF also significantly influenced blood pressure in adolescents, mainly in Brazilian adolescents.

Key Words::

• Adolescents
• blood pressure
• epidemiology
• multilevel modeling
• social factors

Funding

The HELENA Study received financial support by the European Community Sixth RTD Framework Program [contract FOOD-CT-2005-007034]. The authors take sole responsibility for the content of this article. This study was also supported by a grant from the Spanish Ministry of Health: Maternal, Child Health and Development Network [no. RD08/0072], a grant from the Spanish Ministry of Education [EX-2008-0641] and the Swedish Heart-Lung Foundation [20090635]. Augusto César de Moraes was given a scholarship from São Paulo Research Foundation - FAPESP [proc. 2011/11137-1 and 2011/20662-2]. Luis A. Moreno was given a scholarship as a visiting professor from the Brazilian government by the Science without Borders Program by CNPq (National Council of Technological and Scientific Development) and CAPES (Coordination of Improvement of Higher Education Personnel) [proc. 007/2012]. The GENUD Research Group was co-financed by the European Regional Development Fund [MICINN-FEDER].

Authors’ contributions

ACFM and HBC were the principal design researchers responsible for the data collection in the BRACAH study; LAM, MY, MS, AK, KW, LB and FG were the principal design researchers responsible for the data collection in the HELENA study; ACFM, HCB and LAM analyzed and performed data interpretation, as well as helping to draft the manuscript. All authors were involved in revising the manuscript critically for important intellectual content. ACFM was primarily responsible for the final content. All authors read and approved the final manuscript.

Declaration of interest: The authors state no conflicts of interest.

Supplementary material available online

Supplementary Tables IA, B showing β coefficients from regression models for blood pressure levels in girls and boys.