Abstract
ObjectivesWe examined the social distribution of a comprehensive range of cardiovascular risk factors (CVRF) in a Swiss population and assessed whether socioeconomic differences varied by age and gender.MethodsParticipants were 2960 men and 3343 women aged 35–75 years from a population-based survey conducted in Lausanne, Switzerland (CoLaus study). Educational level was the indicator of socioeconomic status used in this study. Analyses were stratified by gender and age group (35–54 years; 55–75 years).ResultsThere were large educational differences in the prevalence of CVRF such as current smoking (Δ = absolute difference in prevalence between highest and lowest educational group:15.1%/12.6% in men/women aged 35–54 years), physical inactivity (Δ = 25.3%/22.7% in men/women aged 35–54 years), overweight and obesity (Δ = 14.6%/14.8% in men/women aged 55–75 years for obesity), hypertension (Δ = 16.7%/11.4% in men/women aged 55–75 years), dyslipidemia (Δ = 2.8%/6.2% in men/women aged 35–54 years for high LDL-cholesterol) and diabetes (Δ = 6.0%/2.6% in men/women aged 55–75 years). Educational inequalities in the distribution of CVRF were larger in women than in men for alcohol consumption, obesity, hypertension and dyslipidemia (p<0.05). Relative educational inequalities in CVRF tended to be greater among the younger (35–54 years) than among the older age group (55–75 years), particularly for behavioral CVRF and abdominal obesity among men and for physiological CVRF among women (p<0.05).ConclusionLarge absolute differences in the prevalence of CVRF according to education categories were observed in this Swiss population. The socioeconomic gradient in CVRF tended to be larger in women and in younger persons.
Highlights
In high income countries, cardiovascular disease (CVD) disproportionately affects the lower socioeconomic groups [1], probably reflecting an unequal distribution of cardiovascular risk factors (CVRF) across society [2,3,4] and differential access to and/or use of treatment [5]
The overall aim of our study is to provide an updated and comprehensive assessment of social inequalities in major risk factors for lifestyle-related diseases in a French-speaking Swiss town
Excluded participants were more likely to have CVRF than those included in the analysis and they were more likely to be in the lowest educational group than those included in the study (OR = 1.69; 95%confidence intervals (CI): 1.27; 2.27)
Summary
Cardiovascular disease (CVD) disproportionately affects the lower socioeconomic groups [1], probably reflecting an unequal distribution of cardiovascular risk factors (CVRF) across society [2,3,4] and differential access to and/or use of treatment [5]. In Europe, there appears to be a North-South gradient in socioeconomic inequalities in CVD, with larger differences in Northern than in Southern European countries [7]. Strong socioeconomic inequalities in CVRF have frequently been reported in Northern European regions such as in Scandinavian countries or in the United Kingdom [8,9,10], while in several Southern European countries such as Italy, Greece or Spain the association between socioeconomic indicators and CVRF seems to be weaker [11,12,13,14]. Cavelaars et al [2] noted a North-South pattern in the social distribution of smoking and vegetable consumption with small associations with educational level in Southern European regions
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