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

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.