Socioeconomic status and cardiovascular risk factors in young adults: a cross-sectional analysis of a Brazilian birth cohort

Abstract

Introduction: In high-income countries, persons of high socioeconomic status (SES) have a lower cardiovascular risk. However, in middle and low-income countries, the results are controversial. Objective: To evaluate the association between family income and cardiovascular risk factors in young adults. Methods: A total of 2,063 individuals of a birth cohort initiated in 1978/79 in the city of Ribeirão Preto, Brazil, were evaluated at age of 23/25 years. Cardiovascular risk factors (hypertension, sedentary lifestyle, smoking, low high-density lipoprotein (HDL)-cholesterol, high low-density lipoprotein (LDL)-cholesterol, high fibrinogen, insulin resistance, diabetes, abdominal and total obesity, and metabolic syndrome) were evaluated according to family income. Income was assessed in multiples of the minimum wage. Simple Poisson regression models were used to estimate the prevalence ratios (PR) with robust estimation of the variance. Results: High-income women showed lower prevalences of low HDL-cholesterol (PR = 0.47), total obesity (PR = 0.22), abdominal obesity (PR = 0.28), high blood pressure (PR = 0.28), insulin resistance (PR = 0.57), sedentary lifestyle (PR = 0.47), metabolic syndrome (PR = 0.24), and high caloric intake (PR = 0.71) (p < 0.05). High-income men showed lower prevalences of low HDL-cholesterol (PR = 0.73) and sedentarism (PR = 0.81) (p < 0.05). These results may be explained by the fact that high-income women pay more attention to healthy habits and those with the lowest family income are least likely to access health services resources and treatments. Conclusion: Women were in the final phase of the epidemiologic transition, whereas men were in the middle phase.

Fatores associados em adultos jovens com história familiar de hipertensão arterial e diabetes

“…Os cuidadores dos estudantes não estimulam a prática de exercício físico e falham em promover uma alimentação saudável a partir da infância, ampliando os fatores de risco para surgimento de doenças crônicas. Silva et al (2020) esclarecem que a renda se mostra um fator preditor que exerce influência no hábito de comprar hortaliças e frutas, ou seja, indivíduos com menor nível econômico se mostram menos propensos a consumir esses tipos de alimentos. Outro aspecto relevante, além do baixo consumo de frutas e verduras, é a redução nas atividades físicas, situação que configura risco entre jovens e adolescentes, situação reforçada, provavelmente, pela ascensão de jogos eletrônicos que se tornaram mais comuns do que brincadeiras ao ar livre.…”

Cardiovascular risk factors across different levels of urbanization in Brazilian Afro‐derived communities (quilombos)

“…This framework helps to capture how and why CVD and other chronic disease have become pervasive throughout the globe. While CVD is associated with non‐modifiable risk factors such as age, sex and hereditary factors, increases in modifiable risk factors such as smoking, diet, physical activity levels, and excessive alcohol consumption are largely implicated in the rapid increase of CVD (Bezerra et al, 2013; Brown‐Riggs, 2016; Gaziano et al, 2007; Global Burden of Disease, 2016; Gomes et al, 2010; Joseph et al, 2017; Silva et al, 2020).…”

“…For example, a study of more than 1.7 million individuals from seven different high‐income countries (HIC), found a substantial association between low socioeconomic status (SES) and increased prevalence of chronic disease risk factors such as smoking, alcohol consumption, sedentary lifestyle, hypertension, obesity, and diabetes (Stringhini et al, 2016). However, studies conducted in middle‐income and low‐income countries (LMIC), in addition to being scarce, have reported conflicting results (Ajayi et al, 2016; Rosengren et al, 2019; Silva et al, 2020). Several studies support that people with low SES in LMICs have better chronic disease risk profiles compared to people with low SES in HIC; however, these groups face higher incidence and mortality from these diseases, likely due to lowered access and availability of healthcare and management programs (Rosengren et al, 2019).…”

“…These diseases are becoming a major challenge for health systems and prevent the economic development of many countries. Contrary to common perceptions, 80% of chronic disease deaths occur in low and middle-income countries (De-Graft Aikins et al, 2012;Silva et al, 2020). In Brazil, chronic diseases account for 74% of all registered deaths (WHO, 2018) and are most prevalent in the low-income social groups of the population due to increased exposures to risk factors and reduced access to health services (Felisbino-Mendes et al, 2014;Luz et al, 2020).…”