Treatment of hypertension in Germany: Is there a social gradient?

Abstract

Objectives: Effective hypertension control remains low without much improvement since the 1990s. However, information is limited whether and how social status impacts on hypertension control. Methods: Data from the German Health Survey 1998 are used to explore the role of social status according to educational achievement in treating hypertension, adjusted for key determinants in a logistic regression. Results: Actual as well as population prevalence (≥140 mmHg/≥90 mmHg) is highest in the lowest of the three social classes with 59.4 and 51.9% as compared to 44.5 and 40.5% in the highest. Physician contacts during the previous year were also highest in the lower class with 76.0% as compared to 59.0% in the highest. The logistic regression revealed insignificant odds ratios (OR) of 1.46 for the highest and 1.12 for the middle class for treatment of known hypertension after adjusting for gender (OR for females, 1.38), age (OR for 60-69 years, 13.13), GP visits (OR, 1.43) and living in East Germany (OR, 1.56). Conclusions: German survey data for antihypertensive treatment do not show any significant disadvantage for the lowest social class. © 2011 Swiss School of Public Health.