Socioeconomic characteristics of patients with coronary heart disease in relation to their cardiovascular risk profile

Abstract

ObjectivePeople’s socioeconomic status (SES) has a major impact on the risk of atherosclerotic cardiovascular disease (ASCVD) in primary prevention. In patients with existing ASCVD these associations are less documented. Here, we evaluate to what extent SES is still associated with patients’ risk profile in secondary prevention.MethodsBased on results from a large sample of patients with coronary heart disease from the European Action on Secondary and Primary Prevention through Intervention to Reduce Events study, the relationship between SES and cardiovascular risk was examined. A SES summary score was empirically constructed from the patients’ educational level, self-perceived income, living situation and perception of loneliness.ResultsAnalyses are based on observations in 8261 patients with coronary heart disease from 27 countries. Multivariate logistic regression analyses demonstrate that a low SES is associated (OR, 95% CI) with lifestyles such as smoking in men (1.63, 1.37 to 1.95), physical activity in men (1.51, 1.28 to 1.78) and women (1.77, 1.32 to 2.37) and obesity in men 1.28 (1.11 to 1.49) and women 1.65 (1.30 to 2.10). Patients with a low SES have more raised blood pressure in men (1.24, 1.07 to 1.43) and women (1.31, 1.03 to 1.67), used less statins and were less adherent to them. Cardiac rehabilitation programmes were less advised and attended by patients with a low SES. Access to statins in middle-income countries was suboptimal leaving about 80% of patients not reaching the low-density lipoprotein cholesterol target of <1.8 mmol/L. Patients’ socioeconomic level was also strongly associated with markers of well-being.ConclusionThese results illustrate the complexity of the associations between SES, well-being and secondary prevention in patients with ASCVD. They emphasise the need for integrating innovative policies in programmes of cardiac rehabilitation and secondary prevention.

Smoking cessation in patients with established coronary artery disease: data from the POLASPIRE survey

“…In line with previous reports, increasing age, cardiac rehabilitation following a cardiovascular event, absence of passive smoking, and high socio-economic status were associated with smoking cessation in our population [5,17,18]. On the other hand, we did not find evidence that depression and anxiety are related to the persistent smoking.…”

The efficacy of mobile health in alleviating risk factors related to the occurrence and development of coronary heart disease: A systematic review and meta‐analysis

“…These results are similar to the results of Dale, 39 indicating that the mhealth treatment is important to alleviate the occurrence and development of CHD. However, study 40 has shown that, compared with changes in cholesterol, 10 year ASCVD risk can better reflect the close relationship between blood lipids and the incidence of coronary heart disease. There is no research related to 10 year ASCVD risk in the literature included in this study, and it can be combined with mhealth research in the future.…”

Lack of Social Support and Its Role on Self-Perceived Health in a Representative Sample of Spanish Adults. Another Aspect of Gender Inequality

“…Perceived social support protects lonely people, and this has become more evident during the COVID-19 pandemic [49]. EUROASPIRE-7 study, conducted across 27 European countries, found that social isolation and low level of education were associated with various cardiovascular risk factors [50].…”