Socioeconomic factors and hypertension in Al-Ain, UAE

Abstract

The United Arab Emirates (UAE), like many other developing countries, has witnessed a rapid development in many aspects of life during the last three decades. The discovery of oil in the middle of the last century has contributed to significant social change and UAE, along with other Gull Arab States, have experienced a rapid transition in its socio-economic status.
Rapid economic growth in IJAE has brought about marked changes both in lifestyles and in patterns of health and disease. With the greater availability of housemaids, cars, televisions and other sophisticated household appliances, the lifestyles of UAE nationals have become more sedentary, and watching television and eating snacks are some of the main4eisure-time
activities. The consumption of traditional food items have also decreased with urbanization and life-style changes in the UAE community, and hypertension have become a major public health problem. To date, there are no systematic studies of the relationship between hypertension and socioeconomic factors such as income and demographic factors including
education and occupation in the UAE population have been undertaken. Since each community has its own common and unique socioeconomic determinants for cardiovascular diseases, particularly hypertension, it is important to study these variables in individual communities. In the UAE, it is believed that the effect of income, education and occupation
are much weaker than in the developed countries due to the differences in the educational levels and the differences in the economy of the country. This study investigated the association between the incidence of hypertension and socioeconomic factors including income.
The study included 500 hypertensive adults aged 20-65 years from the Primary Health Care (PHC) Clinics along with a randomly selected sample of 500 normotensive control subjects. Face-to-face interviews were done and data were gathered on socio-economic status (SES). age, gender, nationality, educational level, occupation, place of living (urban and semiurban), parity, income level, cigarette smoking habit, physical activity, lifestyle habits, body mass index, social support, chronic life difficulties, perceived stress and iritability.
Hypertension was defined according to World Health Organization (WHO) criteria as Systolic Blood Pressure (51W) > 140 mm Hg and/or Diastolic Blood Pressure (DBP) > 90 mm Hg and/or on antihypertensive treatnent. The data were analyzed using the Statistical Packages for Social Sciences (SPSS). Student's t-test, Mann-Whitney test, chi-square test and ANOVA test were used to assess the relationship between these factors and the incidence hypertension. SBP and DBP.
For the Arab expatriates, the present study found a statistically significant association between socioeconomic factors (particularly income and education) and the incidence of hypertension and elevated blood pressure. In contrast, the study has also found no significant relationship between the incidence of hypertension and socioeconomic factors among UAE
nationals.
The results of this study showed a significant relationship between most of the studied psychosocial risk factors and hypertension. There was a significant relationship between hypertension and social support, perceived stress and chronic life difficulties. The results provided clear evidence that the effect of psychosocial risk factors in the development of
hypertension is more pronounced among Arab expatriates compared to UAE nationals. Not surprisingly, the study has also found a significant relationship between the incidence of hypertension and some of the known hypertension-related risk factors. A significant association was found between the incidence of hypertension and body mass index, cholesterol abnornmlity. smoking, saturated fat consumption, excessive salt constiiiiption. physical exercise, cardiovascular disease, diabetes, renal problems and family history of hypertension. In addition, psychosocial stressors and other personal health habits such as diet (saturated fat consumption), physical activity, smoking and body weight are significantly related to blood lipid profiles.
There was also a significant association between many of the above-mentioned risk factors
and the socioeconomic factors, particularly, income and education. However, the pattern and
the strength of these associations were not similar for UAE nationals and expatriates. The
study observed relatively lower levels of the above-mentioned risk factors among UAE
nationals with low socioeconomic status as compared to the expatriate group. Differences
between the two groups with regard to the relationship between socioeconomic factors and
the incidence hypertension is interesting and deserves further exploration. In conclusion, it
would seem that the differences in SES and the prevalence ofhypertension morbidity are
mediated at least in part, by some hypertension-related risk factors observed in this study.
Despite the limitations and difficulties in measuring SES (particularly income), the evidence
observed in this study that SES is a major determinant of hypertension especially among
expatriates living in the UAE is of significant clinical importance.