Eastern Mediterranean Health Journal · Dec 8, 2025

Socioeconomic disparities in hypertension prevalence among adults in Islamic Republic of Iran

By Moghaddam TZ, Dikici E, Pourfarzi F et al.

BACKGROUND: Hypertension is a major risk factor for non-communicable disease morbidity and mortality globally, and its prevalence varies significantly across socioeconomic groups. AIM: To investigate the socioeconomic disparities in hypertension prevalence in northwestern Islamic Republic of Iran, focusing on gender and socioeconomic and education status. METHODS: We analysed data on Ardabil, Northwest Islamic Republic of Iran, extracted from the Persian cohort study, a population-based study involving 20 149 individuals aged 35-70 years, conducted between May 2017 and February 2020. Hypertension status was determined through self-reported diagnosis and clinic records. We used the multilevel logistic regression models to assess factors associated with hypertension prevalence, and the slope index and relative index of inequalities with Blinder-Oaxaca decomposition to quantify socioeconomic inequalities. RESULTS: Older age, male sex, lower education level, marital status, lower economic status, and higher body mass index were the main determinants of hypertension prevalence. Prevalence was 25.1% (95% CI: 24.3-25.9) among men and 32.5% (95% CI: 31.4-33.7%) among women. It was substantially higher among the poorest population groups than the richest (25.8% vs 13.7% crude rate and 28.4% vs 19.9% adjusted rate). Individuals with lower education status exhibited higher hypertension rates (22.3%) (95% CI = 19.9-24.9). These disparities were more pronounced among women (CI = -0.167) than men (CI = -0.041). CONCLUSION: Significant disparities exist in hypertension prevalence in northwestern Islamic Republic of Iran: prevalence was higher among individuals with lower socioeconomic and education levels and among women. Interventions to address the gender and socioeconomic inequalities and promote education attainment are crucial to effectively control hypertension among the population group.

doi.org/10.26719/2025.31.11.621Open accessPubMed 41549573Populations