Socioeconomic inequalities in health-related quality of life between men and women, 5years after a coronary angiography.

Anastase Tchicaya,Nathalie Lorentz

doi:10.1186/s12955-016-0570-z

Abstract

BackgroundThe aim of this study is to measure gender differences in health-related quality of life (HRQOL) among men and women patients with cardiovascular diseases (CVD), and to assess the impact of socioeconomic factors on HRQOL between men and women, 5 years after a coronary angiography.MethodsThe study included 1,289 out of 4,391 patients who had undergone an angiography in the National Institute for Cardiac Surgery and Interventional Cardiology, Luxembourg in 2008/2009. Four indicators of the WHOQOL-BREF questionnaire (Self-rated health, Quality of life, Physical health, and Psychological health) were used in this study as interest variables. To assess the socioeconomic inequalities in HRQOL between men and women, general linear models were constructed for every indicator, with educational level and living conditions as predictors, and demographic variables, cardiovascular risk factors, and cardiovascular events as covariates.ResultsWomen were older than men (71.5 versus 68.1, p <0.0001) and less likely to be married. HRQOL was significantly different between men and women despite the fact they had the same socioeconomic status. The average score for overall health was 3.7/5 for men versus 3.5/5 for women; similarly, the life quality score was 3.8/5 for men versus 3.6/5 for women. Education level and living conditions were associated with lower HRQOL scores in men and women.ConclusionThe findings showed that women have lower HRQOL than men regarding self-rated health, quality of life, and the WHOQOL-BREF physical and psychological domains 5 years after a coronary angiography. Socioeconomic inequalities affect HRQOL, and their influence was similar in both men and women. Socioeconomic inequalities in HRQOL in women and men with CVD are strong 5 years after a coronary angiography. Taking into account differences in gender and socioeconomic status in intervention strategies to substantially reduce the differences observed between women and men could help improve the effectiveness of secondary prevention.

Highlights

The aim of this study is to measure gender differences in health-related quality of life (HRQOL) among men and women patients with cardiovascular diseases (CVD), and to assess the impact of socioeconomic factors on HRQOL between men and women, 5 years after a coronary angiography
Data derived from a follow-up study of 4391 patients admitted for a coronary angiography in Institute of Cardiac Surgery and Interventional Cardiology (INCCI) from 1 January 2008 to 31 December 2009 who participated in the research project ‘State of health and its determinants -ESANDE’ [24]
This study provides evidence on the association between socioeconomic status and HRQOL scores among CVD patients 5 years after a coronary angiography, evidence that may be useful to policy-makers, and be useful in clinical settings

Summary

Introduction

The aim of this study is to measure gender differences in health-related quality of life (HRQOL) among men and women patients with cardiovascular diseases (CVD), and to assess the impact of socioeconomic factors on HRQOL between men and women, 5 years after a coronary angiography. Cardiovascular diseases (CVD) are the leading cause of death or morbidity worldwide [1, 2] These are more common in men than in women, but in the past, they have often been diagnosed at a late age [2,3,4]. In the USA, for example, the lifetime risk of developing CVD after age 40 was 49% in men and 32% in women [3] These disparities persist between men and women in cardiovascular health and care, and in the delivery and outcomes of coronary revascularization therapy [3]. Many studies have shown that health-related quality of life in women after a coronary event or with cardiovascular disease is lower than in men [2, 10,11,12,13,14,15]. Women reported lower HRQOL scores than men in both the ‘EuroQoL self-rated health grade and RAND-36’ [15]

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