Educational attainment and arterial hypertension in 160,000 Mexican adults: a pooled subanalysis of three surveys endorsed by the Collaborative Group on Arterial Hypertension
Year: 2026
Type: article
Abstract: Educational attainment is a key structural social determinant of health linked to arterial hypertension. However, evidence from Mexico, particularly regarding potentially modifiable mediators, is limited. Here, we evaluated the association between educational attainment and arterial hypertension and explored potential mediators. We pooled harmonized data from adults (≥ 20 years) screened in Mexico May Measurement Month surveys in 2021, 2022, and 2023. Arterial hypertension was defined as prior medical diagnosis, use of blood pressure (BP)–lowering medication, and/or systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg. Educational attainment was categorized as 0–6, 7–12, and ≥ 13 years. Sex-stratified Poisson models with robust variance were used to estimate adjusted prevalence ratios. Exploratory mediation analyses were conducted. Among 166,251 participants (60% women; mean age, 47 ± 17 years; 37% with arterial hypertension), we found an inverse association between educational attainment and arterial hypertension. Compared with adults with ≥ 13 years of education, those with 0–6 and 7–12 years of education had 22% (95% CI: 1.19–1.24) and 10% (95% CI: 1.09–1.12) higher prevalence of hypertension, respectively. The association was stronger in women than in men. When diabetes, alcohol intake, and physical inactivity were considered jointly, they explained between 14 to 19% of the association between education and arterial hypertension. Lower educational attainment were positively associated with a higher prevalence of arterial hypertension, and modifiable factors explained approximately one-fifth of this association. These results suggest that educational attainment should be considered in BP screening and risk factor management.
Source: BMC Public Health
Authors: Collaborative Group on Arterial Hypertension, Neftali Eduardo Antonio-Villa, María Guadalupe Berumen-Lechuga, Megan Carolina Cerda-Mancillas, Víctor M Camarillo-Nava, Cleto Alvarez-Aguilar, Luis Rey García-Cortes, Héctor Armando Rincón-León, Laura Avila-Jiménez, Ricardo Castrejón-Salgado, Moises Moreno-Noguez, Julio Manuel Medina Serrano, Luis Alcocer, José Elpidio Andrade-Pineda, Dennice Cebreros-Santiago, Marcos F Moreno-Martínez, Arian Barrientos-Juarez, Martín Eduardo Montaño-Portillo, Cristian Mercado-Esquivel, G. Cruz-Arteaga, Andrés Rocha-Aguado, Danae Pérez-López, Miriam Ramirez-Cortez, José Mauricio Molina-López, Lilia Miroslava Guzmán-Rivas, Rubén Ríos-Morales, Francisco Vargas-Hernandez, Flor Araceli Nava-Ayala, Alfonso Zempoalteca-Morales, Esther Azcarate-Garcia, Imer Guillermo Herrera-Olvera, Gloria Mendoza-López, Ana Laura Guerrero-Morales, Yesenia Ursúa-Soto, Ana Lilia González-Ramírez, Araceli Gil-Sánchez, Elizabeth García-Cortés, Judith Cruz-Quintanilla, Berenice Cornejo-Vázquez, Noemi del Carmen Luna-Sánchez, Diana Rosario Rubio-Moreno, Oscar Jiménez-Jalpa, Ma. Adriana Cruz-Arce, Carlos José Molina-Pérez, Mauricio Espinosa-Lugo, Fabiola Alday-Medina, Zita María de Lourdes Reza-Garay, Rocio Bautista-De Anda, Anaghielly Sánchez-Perez, Reyna Pérez-Martínez, María Emiliana Avilés-Sánchez, Maria Guadalupe Rodiles-Alvarez, Yazmin Jocelyn Julian-Hernández, Maria Del Carmen Hernández-Vargas, Elvira Evelyn Robles-Rentería, Claudia Leticia Sánchez-Nava, Jaime Juárez-González, Josué Jaciel Aguilar-Reyes, César Carlos López-García, Tania Pérez-Escobedo, Jarek Miguel Alejandro Rodríguez, Judith M Hernández De la Cruz, María Isabel López Alejandro, Alma Beatriz Peña Jiménez, Mariely Guadalupe Liceaga López, Abilene del Carmen Camacho Aguilera, Luis Felipe Ortiz Castillo, Libna Aridai Chan Medina, Miguel Adrián Che May, Ana Silvia Briceño Moo, José Ramiro Flores Chan, María Fernanda Dorantes Franco, Yisel Denis Hernández Cuevas, Abraham Ramírez Gutiérrez, Eddysher Raymundo May López, Karla Reyna Navarro-Fuentes, Brenda Gisela Castillejos-Anleu, Edward Ochoa-Tapia, Liliana del Carmen Melchor-Ruiz, Carlos Ramiro Lozano-Mendoza, Ricardo Alfonso Rangel-Zertuche, Gabriela Escott-Pérez, María Magali Rosales-Rivera, Luis Carlos Martinez-Reyna, Beatriz Cecilia Franco-Vergara, Ruth Raquel Villarreal-Delgado, Teresa del Carmen Frayre-Pérez, José Eduardo Guajardo-Iruegas, Magdalena Cervantes-Carranza, Laura Lucía Sarmiento-Rodríguez, Rocio Guadalupe Galván-Hernandez, Norma Isabel Contreras-Ríos, Armida Barron-Hernández, Sandra Guerrero, Rosa Elia Ramírez-Hernández, Enedelia Herrera-Esparza, Elizabeth Bermejo-Santoyo, Gerardo Muñoz Cortés, Andrés Eusebio Olalde Gil, Edgar Josue Palomares Vallejo, Brenda Paulette Morales Hernández, Claudia Janeth Morfín Macias, Marco Antonio León-Mazón, Sarahi Rodríguez-Rojas, Martín Figueroa-Gaspar, Aurea Atanacia Barreto-Gonzalez, Alma Leticia Flores-Sámano, Margie Icxiuh Melgar-Aranda, Miguel Trujillo-Martínez, María de Lourdes Escobar-Sánchez, Ana Ever Zamorano-Andres, Erika Conde-Valencia, Ivón Romero-Pascual, Sarai Noguerón-Benítez, Patricia Seefoó Jarquin, Brenda Gómez-González, Claudio Martinez-Casasola, Nadia Aguirre-Acosta, Maricruz Vazquez-Muñoz, Gabriel Taboada-Contreras, Kelly Galindo-Pozas, Evelyn López-Rojas, Karen Zepeda-Romero, Antonio Camacho-Gonzalez, Dulce Samantha Ortiz-Fonseca, María Rosario Isabel Robles-Rosas, Martín Alberto Félix-Palma, Francisco Antonio Martínez-Villa, José Luis Félix-Heredia, Roberto Joel Tirado-Reyes, Francisco Javier Ramos-Carrillo, Esteban González-Palomo, Dabria Talasi Hernández-Osnaya, Nathalie Levin-Cohen, Carlos Xavier Valenzuela-y-Torres, Katia Mercado-Fuentes, Ixchel Samara Vieyra-Aguirre, Ana Karola Zamora-Aguilar, Frida Geraldine Rauda-Girón, Israel Torres-Colin, Vidal J González-Coronado, María de la Luz León-Vázquez, Miriam Cabrera-Jiménez, Mariana Guadalupe, Silvia Palomo-Piñón, Silvia Palomo-Piñón
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,290
OpenAlex ID: W7202373697