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Background <p>Despite advances in hypertension treatment, achieving optimal blood pressure control remains a major public health challenge. Socioeconomic status (SES) may influence hypertension management; however, evidence on its associations with pharmacotherapy, lifestyle modification, and self-management education remains limited. In this study, the association between SES and hypertension-related outcomes in the Republic of Korea was investigated.</p> Methods <p>In this nationwide cross-sectional study, data from the 2023 Korea Community Health Survey were analyzed, comprising 231,584 and 228,608 adults for educational attainment and household income analyses, respectively. Hypertension-related outcomes included diagnosed hypertension, pharmacotherapy, lifestyle modification, and self-management education. Crude and age- and sex-adjusted rates were calculated, followed by multivariable logistic regression analyses, adjusting for potential confounders.</p> Results <p>Overall, the prevalence of diagnosed hypertension was 31.3%. Among participants with hypertension, the rates of pharmacotherapy, lifestyle modification, and self-management education were 95.9%, 23.8%, and 15.5%, respectively. The multivariable analyses showed a dose–response relationship between SES and outcomes: participants with primary school education or less had higher odds of diagnosed hypertension (odds ratio, 1.79; 95% confidence interval, 1.71–1.88) and pharmacotherapy use (2.04; 1.67–2.50) but lower odds of lifestyle modification engagement (0.47; 0.43–0.50) and receiving self-management education (0.34; 0.31–0.38) compared to those with college degree or higher. Notably, these socioeconomic gradients remained robustly consistent across all strata, while significantly steeper gradients were observed among females and younger adults (&lt; 65&#xa0;years). Analyses by household income showed similar patterns of associations, although with slightly weaker magnitudes.</p> Conclusions <p>Lower SES was associated with a higher prevalence of diagnosed hypertension and pharmacotherapy use but lower participation in lifestyle modifications and self-management education. Strengthening tailored self-management education and lifestyle modification support for socioeconomically disadvantaged groups may be an important strategy to reduce hypertension-related disparities.</p>

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Socioeconomic gradients in hypertension prevalence and management: a cross-sectional study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月15日

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  • Eunji Kim,
  • Hokyou Lee,
  • YunJae Jung,
  • Hyeon Chang Kim

摘要

Background

Despite advances in hypertension treatment, achieving optimal blood pressure control remains a major public health challenge. Socioeconomic status (SES) may influence hypertension management; however, evidence on its associations with pharmacotherapy, lifestyle modification, and self-management education remains limited. In this study, the association between SES and hypertension-related outcomes in the Republic of Korea was investigated.

Methods

In this nationwide cross-sectional study, data from the 2023 Korea Community Health Survey were analyzed, comprising 231,584 and 228,608 adults for educational attainment and household income analyses, respectively. Hypertension-related outcomes included diagnosed hypertension, pharmacotherapy, lifestyle modification, and self-management education. Crude and age- and sex-adjusted rates were calculated, followed by multivariable logistic regression analyses, adjusting for potential confounders.

Results

Overall, the prevalence of diagnosed hypertension was 31.3%. Among participants with hypertension, the rates of pharmacotherapy, lifestyle modification, and self-management education were 95.9%, 23.8%, and 15.5%, respectively. The multivariable analyses showed a dose–response relationship between SES and outcomes: participants with primary school education or less had higher odds of diagnosed hypertension (odds ratio, 1.79; 95% confidence interval, 1.71–1.88) and pharmacotherapy use (2.04; 1.67–2.50) but lower odds of lifestyle modification engagement (0.47; 0.43–0.50) and receiving self-management education (0.34; 0.31–0.38) compared to those with college degree or higher. Notably, these socioeconomic gradients remained robustly consistent across all strata, while significantly steeper gradients were observed among females and younger adults (< 65 years). Analyses by household income showed similar patterns of associations, although with slightly weaker magnitudes.

Conclusions

Lower SES was associated with a higher prevalence of diagnosed hypertension and pharmacotherapy use but lower participation in lifestyle modifications and self-management education. Strengthening tailored self-management education and lifestyle modification support for socioeconomically disadvantaged groups may be an important strategy to reduce hypertension-related disparities.