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Current Hypertension Reviews


ISSN (Print): 1573-4021
ISSN (Online): 1875-6506

Research Article

Minimal Contribution of the Social Determinants of Health to the Prevalence of Hypertension among Egyptian Public Servants

Author(s): Ehab Salah Eshak*, Nashwa Nabil Kamal and Nashaat Nabil Kamal

Volume 19, Issue 2, 2023

Published on: 17 April, 2023

Page: [130 - 138] Pages: 9

DOI: 10.2174/1573402119666230302090924

Price: $65


Background: Previous research suggests the role of social determinants of health (SDH) in the prevalence of hypertension.

Objective: The study aimed to estimate the contribution of SDH to the prevalence of hypertension.

Methods: We recruited 3072 Egyptian public servants who answered a self-administered questionnaire, including hypertension history. We measured the participants’ blood pressure with standardized procedures. The logistic regression models were used to assess the associations between SDH and hypertension.

Results: The prevalence of hypertension was 28.2% (34.2% in males and 22.5% in females). The prevalence of undiagnosed hypertension was 16.3% (23.9% and 9.2%, respectively); thus, 57.8% of the hypertensive subjects were unaware of their high blood pressure status. SDH were associated with the odds of having hypertension in the unadjusted analyses. Higher education, being single, and having minor family members were associated with low odds of hypertension. On the other hand, non-professional occupations, job hours, household income, total family members, and work-family conflicts were associated with higher odds of hypertension. However, in the multivariable analyses, which included all SDH and adjusted for age, gender, smoking, physical activity, body mass index, medical history of chronic diseases, and family history of hypertension, only job hours were associated with the odds of having hypertension and undiagnosed hypertension: odds ratio (95% CI) = 1.07 (1.01-1.14) and 1.11 (1.02-1.20), respectively.

Conclusion: SDH contributed minimally to the odds of having hypertension among public officials in Minia, Egypt. Civil servants with long working hours should be tracked with regular blood pressure monitoring as a high-risk group for hypertension.

Keywords: Hypertension, SDH, body mass index, chronic diseases, blood pressure, morbidities.

Graphical Abstract
Zhou B, Carrillo-Larco RM, Danaei G. et al. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: A pooled analysis of 1201 population-representative studies with 104 million participants. Lancet 2021; 398(10304): 957-80.
[] [PMID: 34450083]
Noncommunicable diseases country profiles 2018. Geneva: World Health Organization 2018. Available from:
Ibrahim MM, Rizk H, Appel LJ. et al. Hypertension prevalence, awareness, treatment, and control in Egypt. Results from the Egyptian National Hypertension Project (NHP). Hypertension 1995; 26(6): 886-90.
[] [PMID: 7490144]
Ezzat EM, Amir MAA, Ewais AA. Pattern of hypertension in Fayoum governorate. Asian J Med Health 2019; 17(1): 1-8.
World Health Organization. A conceptual framework for action on the social determinants of health. 2010. Available from:
Havranek EP, Mujahid MS, Barr DA. et al. American heart association council on quality of care and outcomes research, council on epidemiology and prevention, council on cardiovascular and stroke nursing, council on lifestyle and cardiometabolic health, and stroke council. Social determinants of risk and outcomes for cardiovascular disease: A scientific statement from the American Heart Association. Circulation 2015; 132(9): 873-98.
[] [PMID: 26240271]
Pantell MS, Prather AA, Downing JM, Gordon NP, Adler NE. Association of social and behavioral risk factors with earlier onset of adult hypertension and diabetes. JAMA Netw Open 2019; 2(5): e193933.
[] [PMID: 31099868]
Zheng C, Wang Z, Wang X. et al. Social determinants status and hypertension: A nationwide cross‐sectional study in China. J Clin Hypertens 2020; 22(11): 2128-36.
[] [PMID: 32882111]
Arabi Basharic F, Janati A, Pezeshki MZ, Khodayari-Zarnaq R, Sadeghi-Ghyassi F, Gholizadeh M. Country-level interventions for the prevention and management of hypertension through the modification of social determinants of health: A systematic review protocol. Syst Rev 2020; 9(1): 152.
[] [PMID: 32580747]
Ibrahim MM. Epidemiology of hypertension in egypt. Saudi J Kidney Dis Transpl 1999; 10(3): 352-6.
[PMID: 18212445]
Hasan D, Emeash A, Mustafa S, Abdelazim G, El-din A. Hypertension in Egypt: A systematic review. Curr Hypertens Rev 2015; 10(3): 134-41.
[] [PMID: 25544289]
Soliman SSA, Guseman EH, Haile ZT, Ice G. Prevalence and determinants of hypertension unawareness among Egyptian adults: The 2015 EHIS. J Hum Hypertens 2021; 35(10): 927-34.
[] [PMID: 33082518]
Elbaz WF, Eissa SSM, Mohamed RA, Aly NK, Abdelhady BM, Reda TM. Essential hypertension among Egyptian adults. Egypt J Hosp Med 2015; 61: 643-52.
El Faramawy A, Youssef G, El Aroussy W. et al. Registry of the Egyptian specialized hypertension clinics: Patient risk profiles and geographical differences. J Hum Hypertens 2020; 34(7): 520-7.
[] [PMID: 31558807]
Eshak ES, Elkhateeb AS, Abdellatif OK. et al. Antecedents of work–family conflict among Egyptian civil workers. J Public Health 2021; 1-10.
[] [PMID: 34458072]
Eshak ES, Baba S, Yatsuya H. et al. Work and family conflicts, depression, and “Ikigai”: A Mediation analysis in a cross-cultural study between Japanese and Egyptian civil workers. J Epidemiol 2022; JE20210338.
[] [PMID: 35153274]
Eshak ES, Abd-El Rahman TA. Depression in public servants of upper Egypt: Gender-specific prevalence and determining factors. J Prevention 2022; 43: 623-38.
Abdelrehim MG, Eshak ES, Kamal NN. The mediating role of work–family conflicts in the association between work ability and depression among Egyptian civil workers. J Public Health 2022; 2022: fdac061.
[] [PMID: 35660929]
Trudel X, Brisson C, Gilbert-Ouimet M, Vézina M, Talbot D, Milot A. Long working hours and the prevalence of masked and sustained hypertension. Hypertension 2020; 75(2): 532-8.
[] [PMID: 31852264]
Cheng H, Gu X, He Z, Yang Y. Dose–response relationship between working hours and hypertension. Medicine 2021; 100(16): e25629.
[] [PMID: 33879739]
Guner U. Is there a relationship between working hours and hypertension? Evidence from the United States. Work 2019; 62(2): 279-85.
[] [PMID: 30829638]
Latief OKAE, Eshak ES, Mahfouz EM. et al. A comparative study of the work-family conflicts prevalence, their sociodemographic, family, and work attributes, and their relation to the self-reported health status in Japanese and Egyptian civil workers. BMC Public Health 2022; 22(1): 1490.
[] [PMID: 35927641]
Vargas CM, Ingram DD, Gillum RF. Incidence of hypertension and educational attainment: The NHANES I epidemiologic followup study. First National Health and Nutrition Examination Survey. Am J Epidemiol 2000; 152(3): 272-8.
[] [PMID: 10933274]
Kobayashi T, Honjo K, Eshak ES, Iso H, Sawada N, Tsugane S. Work–family conflict and self-rated health among Japanese workers: How household income modifies associations. PLoS One 2017; 12(2): e0169903.
[] [PMID: 28207757]
Eshak ES, Kamal NN, Seedhom AE, Kamal NN. Work-family conflict and self-rated health among dwellers in Minia, Egypt: Financial strain vs social support. Public Health 2018; 157: 69-76.
[] [PMID: 29500946]
Unger T, Borghi C, Charchar F. et al. 2020 International Society of Hypertension global hypertension practice guidelines. J Hypertens 2020; 38(6): 982-1004.
[] [PMID: 32371787]

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