Pawel Nadrowski1, Ewa Podolecka2, Andrzej Pajak3, Agnieszka Dorynska3, Wojciech Drygas4,5, Wojciech Bielecki5, Magdalena Kwasniewska5, Andrzej Tykarski6, Arkadiusz Niklas6, Tomasz Zdrojewski7, Michal Skrzypek8, Wojciech Wojakowski2, Krystyna Kozakiewicz2. 1. Division of Cardiology and Structural Heart Diseases, Medical Univer sity of Silesia, Katowice, Poland. pawel24@gmail.com. 2. Division of Cardiology and Structural Heart Diseases, Medical Univer sity of Silesia, Katowice, Poland. 3. Epidemiology and Population Studies Department, Jagiellonian University Medical College, Institute of Public Health, Krakow, Poland. 4. Department of Epidemiology, Institute of Cardiology, Cardiovascular Disease Prevention and Health Promotion, Warsaw, Poland. 5. Department of Social and Preventive Medicine, Medical University of Lodz, Poland. 6. Poznan University of Medical Sciences, Department of Hypertension, Angiology and Internal Medicine, Poznan, Poland. 7. Medical University of Gdansk, Department of Arterial Hypertension and Diabetology, Gdansk, Poland. 8. Medical University of Silesia, Department of Biostatistics, School of Public Health, Katowice, Poland.
Abstract
BACKGROUND: Socioeconomic status (SES) is an important factor for cardiovascular diseases (CVD) development. A decline in death rate from CVD among subjects with high SES is observed in developed countries. The aim of this study was to assess differences in cardiovascular risk (CV) between socioeconomic classes in Poland, a country currently in transition. METHODS: A sample of 15,200 people was drawn. A three stage selection was performed. Eventually, 6170 patients were examined (2013/2014). Data was collected using a questionnaire in face-to-face interviews, anthropometric data and blood tests were also obtained. Education was categorized as incomplete secondary, secondary and higher than secondary school. Monthly income per person was categorized as low (≤ 1000 PLN), medium (1001-2000 PLN) and high (≥ 2001 PLN). Education and income groups were analyzed by prevalence of CVD risk factors and high CVD risk (SCORE ≥ 5%). RESULTS: Higher education was associated with lower prevalence of all analyzed CVD risk factors (p < 0.001), having the highest income with lower prevalence of hypertension, currently smoking, obesity and lower high density lipoprotein cholesterol. Multivariable analysis showed that frequency of high CVD risk decreased with increasing education level (OR 0.61; 95% CI 0.49-0.76; p < 0.01), a similar favorable impact of higher income on high CVD risk was demonstrated in the whole group (OR 0.81; 95% CI 0.67-0.99; p = 0.04). CONCLUSIONS: Socioeconomic status is an independent predictor of high CV risk of death. A favorable impact on the prevalence of high CV risk was demonstrated for education and partly for income in the whole group. It may reflect a transition being undergone in Poland, moreover, it predicts how socioeconomic factors may generate health inequalities in other transitioning countries.
BACKGROUND: Socioeconomic status (SES) is an important factor for cardiovascular diseases (CVD) development. A decline in death rate from CVD among subjects with high SES is observed in developed countries. The aim of this study was to assess differences in cardiovascular risk (CV) between socioeconomic classes in Poland, a country currently in transition. METHODS: A sample of 15,200 people was drawn. A three stage selection was performed. Eventually, 6170 patients were examined (2013/2014). Data was collected using a questionnaire in face-to-face interviews, anthropometric data and blood tests were also obtained. Education was categorized as incomplete secondary, secondary and higher than secondary school. Monthly income per person was categorized as low (≤ 1000 PLN), medium (1001-2000 PLN) and high (≥ 2001 PLN). Education and income groups were analyzed by prevalence of CVD risk factors and high CVD risk (SCORE ≥ 5%). RESULTS: Higher education was associated with lower prevalence of all analyzed CVD risk factors (p < 0.001), having the highest income with lower prevalence of hypertension, currently smoking, obesity and lower high density lipoprotein cholesterol. Multivariable analysis showed that frequency of high CVD risk decreased with increasing education level (OR 0.61; 95% CI 0.49-0.76; p < 0.01), a similar favorable impact of higher income on high CVD risk was demonstrated in the whole group (OR 0.81; 95% CI 0.67-0.99; p = 0.04). CONCLUSIONS: Socioeconomic status is an independent predictor of high CV risk of death. A favorable impact on the prevalence of high CV risk was demonstrated for education and partly for income in the whole group. It may reflect a transition being undergone in Poland, moreover, it predicts how socioeconomic factors may generate health inequalities in other transitioning countries.
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