Endocrine Abstracts

JOINT495

Background: Hypertension remains a global health concern, with its prevalence influenced by socioeconomic determinants and modifiable risk factors. Understanding the interplay between these factors is vital for targeted interventions. This study aimed to investigate the mediating roles of smoking and alcohol consumption in the association between socioeconomic factors (education, wealth index, gender) and blood pressure using data from the National Family Health Survey-5 (NFHS-5) in India.

Methods: We carried out a secondary analysis of data collected from a nationally representative survey (NFHS-5 data) in India. We included 19 23 504 people aged 18 years and above having all the necessary information for analysis. We performed a mediation analysis using structural equation modelling to estimate the natural direct effect (NDE), total effects, and natural indirect effect (NIE) of sex, education and wealth index on systolic and diastolic blood pressure keeping the behavioural habits (smoking and alcohol use) as mediator variables. The analysis was carried out in Stata 16.1.

Results: The sample had a nearly equal distribution of males (51.4%) and females (48.6%). Alcohol use and tobacco consumption were reported by 13.2% and 27.6% of participants, respectively. Women exhibited lower systolic (β= −4.59) and diastolic (β=−2.07) blood pressure compared to men. Lower education levels and higher wealth indices were significantly associated with variations in blood pressure. Mediation analysis showed partial mediation by alcohol and tobacco which were statistically significant (P<0.001). For instance, 17.8% of the reduction in systolic blood pressure associated with being female was mediated by alcohol use, while tobacco accounted for 22.1%. Education’s effect on systolic blood pressure was mediated by 29.7% through alcohol and 27.3% through tobacco. The analysis also revealed that the people in the richer and richest quintiles had significantly higher level of systolic and diastolic blood pressure when compared to those in the poorer and poorest quintiles.

Conclusion: The study highlights the significant mediating roles of smoking and alcohol in the relationship between socioeconomic factors and blood pressure. These findings underscore the importance of integrating behavioural interventions into public health strategies to address hypertension and its risk factors effectively. Targeted approaches considering socioeconomic disparities and behavioral risks are crucial for improving cardiovascular health in diverse populations.