Effects of sociodemographic and socioeconomic factors on stroke development in Lebanese patients with atrial fibrillation: a cross-sectional study

Abstract

Background: Non-communicable diseases, the major cause of death and disability, are susceptible to modifiable and non-modifiable risk factors. Atrial fibrillation (AF) increases the risk of stroke by 4-5 times and can lead to cardiovascular mortality. This study was conducted to assess the effects of different sociodemographic factors on stroke development in patients with AF. Methods: A cross-sectional study was conducted between January and June 2018 on patients recruited from Lebanese community pharmacies. The CHA2DS2-VASc scoring system is utilized as a stroke risk stratification tool in AF patients. Participants with a previous physician diagnosis of AF, documented on medical records, were included in this study. Results: A total of 524 patients were enrolled in the study with a mean age of 58.75 (± SD) ± 13.59 years with hypertension (78.38%) being the most predominant disease. The results showed that obesity (Beta=0.610, p-value =0.011), retirement and unemployment compared to employment (Beta=1.440 and 1.440, p-value=0.001 respectively), divorced/widow compared to married (Beta=1.380, p-value =0.001) were significantly associated with higher CHA2DS2-VASc scores whereas high versus low socio-economic status (Beta=-1.030, p=0.009) and high school education versus primary education level (Beta=-0.490, p-value=0.025) were significantly associated with lower CHA2DS2-VASc scores. Conclusions: The study highlights that the CHA2DS2-VASc score is affected by the presence of various sociodemographic and socioeconomic characteristics in patients with AF. Thus, screening for those factors may predict the progression of cardiovascular disease and may provide an optimal intervention.

Cardiovascular Disease in China: Socioeconomic Status Variation in Prevalence

“…First, individuals with lower-income may more easily be involved in behavioral and lifestyle risk factors, such as poor diet (lower fruit and vegetable consumption), smoking, alcohol consumption, and restricted physical activity, all of which increase the risk of CVD. [20][21][22] In addition, living in lower-income-stressful environments is associated with individual-level health, and previous studies have emphasized the psychophysiological pathway linking income inequality and health. 23,24 Individuals with higher incomes may have certain coping strategies for stress (ie, greater material resources, attention, and information processing ability), which could increase their mental and physical resilience to external stressors.…”

“…), have an earlier recognition and response to warning symptoms, and seek or have greater access to more health services (ie, experienced physicians, evidence-based treatment, and adherence to medication). 20,27,28 Individuals with lower incomes may not be able to afford necessary health care or periodic physical examinations, particularly in rural areas without universal health insurance coverage.…”