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Psychosomatic Medicine 66:184-189 (2004)
© 2004 American Psychosomatic Society


ORIGINAL ARTICLES

Contribution of Early and Adult Factors to Socioeconomic Variation in Blood Pressure: Thirty-Four–Year Follow-up Study of School Children

Mika Kivimäki, PhD, Marja-Liisa Kinnunen, MD, Tuuli Pitkänen, MA, Jussi Vahtera, MD, PhD, Marko Elovainio, PhD and Lea Pulkkinen, PhD

From the University of Helsinki, Helsinki, Finland (M.K., M.E.); the University of Jyväskylä, Jyväskylä, Finland (M.-L.K., T.P., L.P.); and the Finnish Institute of Occupational Health, Helsinki, Finland (M.K., J.V.).

Address reprint requests to: Mika Kivimäki, Department of Psychology, Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, FIN-00250 Helsinki, Finland. Email: mika.kivimaki{at}ttl.fi

OBJECTIVE: To prospectively examine the role of childhood and adulthood factors in the association between socioeconomic status (SES) and adult systolic and diastolic blood pressure (SBP, DBP).

METHODS: One hundred and five boys and 101 girls who were 8 years of age at entry into the study were observed for 34 years in the Jyväskylä Longitudinal Study of Personality and Social Development, Finland. Data were gathered on educational attainment and occupational status, as indicators of SES, and potential explanatory factors related to 0, (14), 27, 36, and 42 years of age. SBP and DBP were assessed at 15 and 42 years of age.

RESULTS: In a structural equation model adjusted for sex and childhood SBP, educational attainment was inversely associated with adult SBP (structural coefficient -0.17, p< .05). Incorporating the effects of parental SES and adult body mass index into the model attenuated this association so that it was no longer significant. Variation in birth weight, unemployment, smoking, alcohol consumption, and use of antihypertensive medication had marginal or no impact on the education–SBP association. No socioeconomic variation was found for DBP or occupational status.

CONCLUSIONS: Prospective evidence suggests a weak association between low educational attainment and development of high SBP. Parental SES and adult BMI were the key explanatory factors for this association.

Key Words: socioeconomic factors, • hypertension, • blood pressure, • life course, • body mass index, • health risk behaviors.

Abbreviations: BMI = body mass index;; BP = blood pressure;; DBP = diastolic blood pressure;; GFI = goodness-of-fit index;; JYLS = Jyväskylä Longitudinal Study of Personality and Social Development;; SBP = systolic blood pressure;; SES = socioeconomic status;; SRMR = root mean squared residual.




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