Abstract

BackgroundTo assess prevalence rates of subjective and objective reports of two cardiovascular disorders (hypertension and hypercholesterolemia) for the same subset of respondents in a large-scale study. To determine whether and the extent to which the socioeconomic health gradient differed in the subjective and objective reports of the two cardiovascular disorders.MethodsData from the first wave (2009/2011) of The Irish Longitudinal Study on Ageing were used (n = 4,179). This is a nationally representative study of community-dwelling adults aged 50+ residing in Ireland. Subjective measures were derived from self-reports of doctor-diagnosed hypertension and high cholesterol. Objective measure of hypertension was defined as: systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg and/or on antihypertensive medication. Objective measure of hypercholesterolemia was defined as: total cholesterol ≥5.2 mmol/L and/or on cholesterol-lowering medication. Objective measures of low-density-lipoprotein cholesterol and high-density-lipoprotein cholesterol were also used. Two measures of socioeconomic gradient were employed: education and wealth. Binary and multinomial logistic and linear regression analyses were used. Analyses were adjusted for an extensive battery of covariates, including demographics and measures of physical/behavioural health and health care utilization.ResultsPrevalence of cardiovascular disorders: prevalence of hypertension and hypercholesterolemia was significantly higher when the cardiovascular disorders were measured objectively as compared to self-reports (64% and 72.1% versus 37% and 41.1%, respectively). Socioeconomic gradient in hypertension: the odds of being objectively hypertensive were significantly lower for individuals with tertiary/higher education (OR, 0.74; 95% CI, 0.60-0.92) and in the highest tertile of the wealth distribution (OR, 0.77; 95% CI, 0.62-0.95). In contrast, the associations between socioeconomic status and self-reported hypertension were not statistically significant. Socioeconomic gradient in hypercholesterolemia: wealthier individuals had higher odds of self-reporting elevated cholesterol (OR, 1.28; 95% CI, 1.03-1.58). Associations between socioeconomic status and objectively measured hypercholesterolemia and low-density-lipoprotein cholesterol were not significant. Higher education and, to a lesser extent, greater wealth were associated with higher levels of high-density-lipoprotein cholesterol.ConclusionsClear discrepancies in prevalence rates and gradients by socioeconomic status were found between subjective and objective reports of both disorders. This emphasizes the importance of objective measures when collecting population data.

Highlights

  • IntroductionTo assess prevalence rates of subjective and objective reports of two cardiovascular disorders (hypertension and hypercholesterolemia) for the same subset of respondents in a large-scale study

  • To assess prevalence rates of subjective and objective reports of two cardiovascular disorders for the same subset of respondents in a large-scale study

  • socioeconomic status (SES) in self-reported and objectively measured hypertension and hypercholesterolemia Table 2 shows the associations between SES and selfreported and objectively measured hypertension

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Summary

Introduction

To assess prevalence rates of subjective and objective reports of two cardiovascular disorders (hypertension and hypercholesterolemia) for the same subset of respondents in a large-scale study. To determine whether and the extent to which the socioeconomic health gradient differed in the subjective and objective reports of the two cardiovascular disorders. Most studies have used self-reported measures of health status and, to a lesser extent, self-reported chronic health conditions. These measures are attractive because they are relatively inexpensive to collect in large-scale surveys and a powerful independent predictor of future morbidity and mortality [12,13,14,15] and health care utilization [16,17]. An attractive alternative is to use objective measures of health status These measures are, expensive to collect and rarely collated in large population studies

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