The Relationships between Cardiovascular Risk Factors and Socio-economic Status in People with Diabetes

1996 ◽  
Vol 13 (1) ◽  
pp. 72-79 ◽  
Author(s):  
N. Unwin ◽  
D. Binns ◽  
K. Elliott ◽  
W.F Kelly
PLoS ONE ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. e0211068 ◽  
Author(s):  
Patricia Rarau ◽  
Justin Pulford ◽  
Hebe Gouda ◽  
Suparat Phuanukoonon ◽  
Chris Bullen ◽  
...  

Author(s):  
Nico Dragano ◽  
Pablo Emilio Verde ◽  
Susanne Moebus ◽  
Andreas Stang ◽  
Axel Schmermund ◽  
...  

Background Social inequalities of manifest coronary heart diseases are well documented in modern societies. Less evidence is available on subclinical atherosclerotic disease despite the opportunity to investigate processes underlying this association. Therefore, we examined the relationship between coronary artery calcification as a sign of subclinical coronary atherosclerosis, socio-economic status and established cardiovascular risk factors in a healthy population. Design Cross-sectional. Methods In a population-based sample of 4487 men and women coronary artery calcification was assessed by electron beam computed tomography quantified by the Agatston score. Socio-economic status was assessed by two indicators, education and income. First, we investigated associations between the social measures and calcification. Second, we assessed the influence of cardiovascular risk factors on this association. Results After adjustment for age, men with 10 and less years of formal education had a 70% increase in calcification score compared with men with high education. The respective increase for women was 80%. For income the association was weaker (among men 20% higher for the lowest compared with the highest quartile; and among women 50% higher, respectively). Consecutive adjustment for cardiovascular risk factors significantly attenuated the observed association of socio-economic status with calcification. Conclusions Social inequalities in coronary heart diseases seem to influence signs of subclinical coronary atherosclerosis as measured by coronary artery calcification. Importantly, cumulation of major cardiovascular risk factors in lower socio-economic groups accounted for a substantial part of this association.


PLoS ONE ◽  
2019 ◽  
Vol 14 (2) ◽  
pp. e0212894
Author(s):  
Patricia Rarau ◽  
Justin Pulford ◽  
Hebe Gouda ◽  
Suparat Phuanukoonnon ◽  
Chris Bullen ◽  
...  

Author(s):  
Demosthenes B. Panagiotakos ◽  
Christos Pitsavos ◽  
Yannis Manios ◽  
Evangelos Polychronopoulos ◽  
Christina A. Chrysohoou ◽  
...  

Background Social status has been related with the prevalence and incidence of cardiovascular disease. The aim of this study is to investigate the relationships between socio-economic status (SES) and clinical and biochemical factors related to coronary heart disease, in a sample of cardiovascular disease-free men and women. Design Cross-sectional survey. Methods During 2001-2002, 1514 men (20-87 years old) and 1528 women (20-89 years old) from the Attica region (Greece) were randomly enrolled into the study. Trends in established and emerging cardiovascular risk factors were examined across the participants' socio-economic status. A special index was developed (years of school by annual income) and three socio-economic classes were created. Results An inverse relationship was found regarding all lipids and glucose levels across the tertiles of the SES index. An inverse association was observed between body mass index, waist-to-hip ratio and SES in men, but not in women. Furthermore, compared to the lowest tertile, individuals who were classified in the highest SES tertile had lower levels of C-reactive protein, fibrinogen, homocysteine, tumour necrosis factor-α, interleukin-6 levels and white blood cell counts, even after adjusting for various potential confounders. Finally, a considerable proportion of men and women reported lack of health knowledge and education. Conclusions An inverse association between SES and factors related to cardiovascular risk exists, but the causal pathway itself requires more detailed explanation before the social status can have explanatory power.


2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Olfa Saidi ◽  
Nada Zoghlami ◽  
Kathleen E. Bennett ◽  
Paola Andrea Mosquera ◽  
Dhafer Malouche ◽  
...  

Abstract Background It is important to quantify inequality, explain the contribution of underlying social determinants and to provide evidence to guide health policy. The aim of the study is to explain the income-related inequalities in cardiovascular risk factors in the last decade among Tunisian adults aged between 35 and 70 years old. Methods We performed the analysis by applying two approaches and compared the results provided by the two methods. The methods were global sensitivity analysis (GSA) using logistic regression models and the Wagstaff decomposition analysis. Results Results provided by the two methods found a higher risk of cardiovascular diseases and diabetes in those with high socio-economic status in 2005. Similar results were observed in 2016. In 2016, the GSA showed that education level occupied the first place on the explanatory list of factors explaining 36.1% of the adult social inequality in high cardiovascular risk, followed by the area of residence (26.2%) and income (15.1%). Based on the Wagstaff decomposition analysis, the area of residence occupied the first place and explained 40.3% followed by income and education level explaining 19.2 and 14.0% respectively. Thus, both methods found similar factors explaining inequalities (income, educational level and regional conditions) but with different rankings of importance. Conclusions The present study showed substantial income-related inequalities in cardiovascular risk factors and diabetes in Tunisia and provided explanations for this. Results based on two different methods similarly showed that structural disparities on income, educational level and regional conditions should be addressed in order to reduce inequalities.


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