Social gradient of CVD risk in Germany before/after unification.

Abstract

A social gradient of cardiovascular risk has been found in several European countries, including the former East and West Germany. Have any changes have occurred in Germany, particularly in the east, since the wall came down? We analyzed the results of three compatible, population-based, interview-and-examination health surveys that were performed in both parts of Germany between 1984 and 1992. Total years of education was the social indicator. Systolic/diastolic blood pressure, body mass index, prevalence of hypertension, obesity, and cigarette smoking showed a social gradient in favor of higher social class groups; the social gradient for total cholesterol and hyper-cholesterolemia in men was less clear. Despite a much higher risk-factor profile in the east, neither a difference between the social gradients of the former East and West Germany nor a clear trend after the wall came down were found. In both areas, the social gradient clearly increased only for women smokers. Overall, we found very little evidence to support the idea that the ferocity of socioeconomic changes in the east had already led to a higher gradient of cardiovascular risk in 1991/1992 relative to that in the western part of the German population.