Socioeconomic gradients of cardiovascular risk factors in China and India: results from the China health and retirement longitudinal study and longitudinal aging study in India.

OBJECTIVES: Cardiovascular disease has become a major public health challenge in developing countries. The goal of this study is to compare socioeconomic status (SES) gradients of cardiovascular risk factors (CVRF) both within and between China and India.

METHODS: We used multivariable logistic regression models to examine the associations between SES and CVRF, using data from the China health and retirement longitudinal study and the longitudinal aging study in India.

RESULTS: The results showed that, compared to illiteracy, the odds ratios of completing junior high school for high-risk waist circumference were 4.99 (95% confidence interval: 1.77-14.06) among Indian men, 3.42 (95% confidence interval: 1.66-7.05) among Indian women, but 0.74 (95% confidence interval: 0.59-0.92) among Chinese women. Similar patterns were observed between educational attainment and high-risk body mass index, and between education and hypertension, based on self-reported physician diagnosis and direct blood pressure measurements.

CONCLUSIONS: SES is associated with CVRF in both China and India. However, this relationship showed opposite patterns across two countries, suggesting that this association is not fixed, but is subjective to underlying causal pathways, such as patterns of risky health behaviors and different social and health policies.