Social Gradients in Cardiovascular Risk Factors and Symptoms of Swedish Men and Women: The Göteborg MONICA Study 1995

Abstract

Background Even though coronary mortality in middle and old age is decreasing, social gradients may be increasing; but they need not necessarily be the same for men and women. In order to develop efficient preventive strategies more knowledge of the current distributions of risk factors both for men and for women is needed. Objective To investigate and to compare the socio-economic gradients for coronary risk factors of men and women. Design A cross-sectional study. Methods We studied 686 men and 825 women aged 25–64 years from a random population sample. Socio-economic status (SES) was classified according to the occupation-based Swedish Socio-economic Index. Results For women, high SES was associated with lower levels of total and low-density lipoprotein cholesterol, lower serum levels of triglycerides, higher levels of high-density lipoprotein cholesterol and lower blood pressure. For men, no relation between occupational status and levels of lipids and blood pressure was found. Obesity was associated with low SES both for men and for women. Socioeconomic differences in smoking habits were more pronounced for women than they were for men. The proportion of post-menopausal women was higher among the unskilled workers, despite there being no difference in age. Optimal risk factor status (non-smoker, total cholesterol level < 5 mmol/l, blood pressure < 140/90 mmHg without treatment and body mass index < 25 kg/m2) was unusual both among men and among women, but 34% of the higher officials among the women had optimal risk factor status, compared with 10% of the unskilled workers. Corresponding values for the men were 16 and 9% (P for interaction 0.09). The relation between low SES and level of low-density lipoprotein cholesterol was independent of smoking, post-menopausal state, use of oestrogen and waist: hip ratio (P = 0.04) and so was the relation between systolic blood pressure and low SES (P = 0.0003). Conclusions In Sweden, low SES exerts a stronger adverse influence on cardiovascular risk factors of women than it does on those of men.

Selection bias in a population survey with registry linkage: potential effect on socioeconomic gradient in cardiovascular risk

“…This study also confirms that high education is associated with lower levels of some cardiovascular risk factors [5]. We have shown significant differences for many of the risk factors between the two educational groups, with similar patterns in both sexes.…”

“…Even in a country like Sweden with a relatively narrow income distribution, there are health differences between social groups [2][3][4][5]. Social inequalities in self-reported health have actually been reported to be larger in Sweden compared to some other European countries [6] and inequalities in the risk of coronary heart disease seems to be greater in northern European countries compared with southern Europe [7].…”

Socioeconomic Status and Overweight/obesity in an Adult Chinese Population in Singapore

“…12,53 Similar analogous findings are noted in cardiovascular studies where low SES exerts a stronger adverse influence on cardiovascular risk factors of women than it does on those of men 54,55 and in diabetic studies where a negative association between SES and prevalence of diabetes was found only among women. 49,56 Not all studies have consistently shown these gender patterns.…”

Birth Weight and Lipids in a National Birth Cohort Study

“…25,26 Whereas a consistent association between high lipid levels and lower socio-economic conditions has been found in women, 23,27-29 the relationship in men has been less consistent. 23,[27][28][29] Using data from the MRC National Survey of Health and Development (NSHD), we study the association between birth weight and lipids in a sample of 53-year-old British men and women followed-up since their birth in 1946. The sample is large enough to allow us to formally test for sex differences in the relationship between birth weight and lipid levels.…”