Socio-economic status and risk factors for cardiovascular disease: A multicentre collaborative study in the international clinical epidemiology network (INCLEN) (original) (raw)
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Bmc Public Health, 2013
Background: Cardiovascular disease (CVD) related deaths is not only the prime cause of mortality in the world, it has also continued to increase in the low and middle income countries. Hence, this study examines the relationship between CVD risk factors and socioeconomic variables in Malaysia, which is a rapidly growing middle income nation undergoing epidemiologic transition. Methods: Using data from 11,959 adults aged 30 years and above, and living in urban and rural areas between 2007 and 2010, this study attempts to examine the prevalence of CVD risk factors, and the association between these factors, and socioeconomic and demographic variables in Malaysia. The socioeconomic and demographic, and anthropometric data was obtained with blood pressure and fasting venous blood for glucose and lipids through a community-based survey. Results: The association between CVD risk factors, and education and income was mixed. There was a negative association between smoking and hypertension, and education and income. The association between diabetes, hypercholesterolemia and being overweight with education and income was not clear. More men than women smoked in all education and income groups. The remaining consistent results show that the relationship between smoking, and education and income was obvious and inverse among Malays, others, rural women, Western Peninsular Malaysia (WPM) and Eastern Peninsular Malaysia (EPM). Urban men showed higher prevalence of being overweight than rural men in all education and income categories. Except for those with no education more rural men smoked than urban men. Also, Malay men in all education and income categories showed the highest prevalence of smoking among the ethnic groups. Conclusions: The association between CVD risk factors and socioeconomic variables should be considered when formulating programmes to reduce morbidity and mortality rates in low and middle income countries. While general awareness programmes should be targeted at all, specific ones should be focused on vulnerable groups, such as, men and rural inhabitants for smoking, Malays for hypertension and hypercholesterolemia, and Indians and Malays, and respondents from EPM for diabetes.
Socioeconomic status and cardiovascular risk in urban South Asia: The CARRS Study
European Journal of Preventive Cardiology, 2015
Socioeconomic status is one of the most powerful predictors of cardiovascular disease (CVD) and its risk factors, although the direction of the relationship between SES and CVD is not stable. 1-4 The available evidence suggests that CVD and its risk factors were originally more common in upper socioeconomic groups (hence the name 'disease of affluence' 5 ) and the direction of the association has gradually changed in western populations throughout the middle of this century so that currently CVD is more common in lower socioeconomic groups. The positive socioeconomic gradient still persists in some of the less industrialized countries. 7-10 Until recently, the social pattern of CVD and its risk factors in the former communist countries was not known.
International Journal of Public Health, 2012
Objectives We evaluated the association between socioeconomic status (SES) and incident cardiovascular disease (CVD) in a sample of the Iranian population. Methods We followed 6,504 participants who were initially free from CVD. At baseline, subjects were assessed for CVD risk factors and self-reported data were obtained for education, occupation, and income. Results After 24,379 person-years of follow-up (median = 4.8 years), 276 incident cases of CVD were detected. There was no significant association between the level of education and the incidence of CVD. In univariate analysis, retired individuals showed a significantly higher incidence of CVD than individuals who were working, and subjects in the highest tertile of income were less likely to suffer CVD than those in the lowest tertile. However, the associations disappeared after adjusting for age and sex. Discussion There was no detectable, independent association between the SES and incident CVD. The counterbalance of the higher exposure to CVD risk factors and better access to health-care services and more appropriate risk factor modification in higher socioeconomic classes might diminish the association of SES and CVD in developing countries.
BMJ open, 2015
In Western countries, lower socioeconomic status is associated with a higher risk of cardiovascular disease (CVD) and premature mortality. These associations may plausibly differ in Asian populations, but data are scarce and direct comparisons between the two regions are lacking. We, thus, aimed to compare such associations between Asian and Western populations in a large collaborative study, using the highest level of education attained as our measure of social status. Cohort studies in general populations conducted in Asia or Australasia. 303 036 people (71% from Asia) from 24 studies in the Asia Pacific Cohort Studies Collaboration. Studies had to have a prospective cohort study design, have accumulated at least 5000 person-years of follow-up, recorded date of birth (or age), sex and blood pressure at baseline and date of, or age at, death during follow-up. We used Cox regression models to estimate relationships between educational attainment and CVD (fatal or non-fatal), as well...
2009
South Asian countries have a high prevalence of coronary heart disease (CAD) in line with their economic development. In these countries, we find nearly one quarter of the total world population in the process of nutritional transition, from poverty to affluence due to rapid economic development. India; in particular , with a population of over one billion has a high burden of CAD. To evaluate the role of socioeconomic and demographic variables on the coronary artery disease. A hospital based case-control study was conducted to investigate the role of social related risk factors on coronary artery disease (CAD) in an urban area of East Delhi from April 2002 to December 2004. To obtain more validate comparisons, a control group also was selected from community of East Delhi. The tools of enquiry were a pre-tested and pre-coded questionnaire , physical examination and laboratory testes. A confidence level of 95% and study power of 80% were considered for the interpretation of possible...
PLOS ONE, 2015
Background A relatively consistent body of literature, mainly from high-income countries, supports an inverse association between socioeconomic status (SES) and risk of cardiovascular disease (CVD). Data from low-and middle-income countries are scarce. This study explores SES differences in cardiovascular health (CVH) in the Republic of Srpska (RS), Bosnia and Herzegovina, a middle-income country. Methods We collected information on SES (education, employment status and household's relative economic status, i.e. household wealth) and the 7 ideal CVH components (smoking status, body mass index, physical activity, diet, blood pressure, total cholesterol, and fasting blood glucose) among 3601 participants 25 years of age and older, from the 2010 National Health Survey in the RS. Based on the sum of all 7 CVH components an overall CVH score (CVHS) was calculated ranging from 0 (all CVH components at poor levels) to 14 (all CVH components at ideal levels). To assess the differences between groups the chi-square test, t-test and ANOVA were used where appropriate. The association between SES and CVHS was analysed with multivariate linear regression analyses. The dependent variable was CVHS, while independent variables were educational level, employment status and wealth index. Results According to multiple linear regression analysis CVHS was independently associated with education attainment and employment status. Participants with higher educational attainment and those economically active had higher CVHS (b = 0.57; CI = 0.
Introduction and Objective: Socio-economic status has been shown to be associated with cardiovascular disease. We aimed to investigate the relationship between socio-economic status and traditional risk factors for cardiovascular diseases in the MASHAD cohort study drawn from a population sample in northeast Iran. Methods: In this cross-sectional study, subjects were divided into three categories of socio-economic status (SES) based on their education level, employment status and monthly income using latent class analysis (LCA). The three SES classes were compared in terms of cardiovascular diseases risk factors. P value less than 0.05 was considered as significant. Results: A total number of 9704 participants were included in the study. Participants with a low SES had significantly lower means of age, physical activity level, waist circumference, systolic blood pressure and LDL-C, and higher means of weight, and hip circumferences. Also, the prevalence of smoking, hypertension and ...
The Lancet
Modifiable risk factors for cardiovascular disease and mortality (26•3% of the PAF), although the single largest risk factor was a low education level (12.5% of the PAF). Ambient air pollution was associated with 13•9% of the PAF for CVD (although different statistical methods were used for this analysis). In MIC and LIC, the importance of household air pollution, poor diet, low education, and low grip strength were larger compared with HIC. Interpretation: The majority of CVD cases and deaths can be attributed to a small number of common, modifiable risk factors. While some factors have extensive global impacts (e.g. hypertension, education), others (e.g. household air pollution, poor diet) vary by a country's economic level. Health policies should focus on risk factors that have the greatest effects on averting CVD and death globally, with additional emphasis on risk factors of greatest importance in specific groups of countries. Funding: See acknowledgements.
International Journal of Epidemiology, 2012
Socioeconomic status is one of the most powerful predictors of cardiovascular disease (CVD) and its risk factors, although the direction of the relationship between SES and CVD is not stable. 1-4 The available evidence suggests that CVD and its risk factors were originally more common in upper socioeconomic groups (hence the name 'disease of affluence' 5) and the direction of the association has gradually changed in western populations throughout the middle of this century so that currently CVD is more common in lower socioeconomic groups. 2-4,6 The positive socioeconomic gradient still persists in some of the less industrialized countries. 7-10 Until recently, the social pattern of CVD and its risk factors in the former communist countries was not known. There has been some debate as to which component(s) of SES are the most important for the socioeconomic gradient in CVD and its risk factors. Some have argued that material conditions (that might relate, for example, to affordability of a healthy diet)