Abstract
In high-income countries, persons of high socioeconomic status (SES) have a lower cardiovascular risk. However, in middle and low-income countries, the results are controversial. To evaluate the association between family income and cardiovascular risk factors in young adults. A total of 2,063 individuals of a birth cohort initiated in 1978/79 in the city of Ribeirão Preto, Brazil, were evaluated at age of 23/25 years. Cardiovascular risk factors (hypertension, sedentary lifestyle, smoking, low high-density lipoprotein (HDL)-cholesterol, high low-density lipoprotein (LDL)-cholesterol, high fibrinogen, insulin resistance, diabetes, abdominal and total obesity, and metabolic syndrome) were evaluated according to family income. Income was assessed in multiples of the minimum wage. Simple Poisson regression models were used to estimate the prevalence ratios (PR) with robust estimation of the variance. High-income women showed lower prevalences of low HDL-cholesterol (PR = 0.47), total obesity (PR = 0.22), abdominal obesity (PR = 0.28), high blood pressure (PR = 0.28), insulin resistance (PR = 0.57), sedentary lifestyle (PR = 0.47), metabolic syndrome (PR = 0.24), and high caloric intake (PR = 0.71) (p < 0.05). High-income men showed lower prevalences of low HDL-cholesterol (PR = 0.73) and sedentarism (PR = 0.81) (p < 0.05). These results may be explained by the fact that high-income women pay more attention to healthy habits and those with the lowest family income are least likely to access health services resources and treatments. Women were in the final phase of the epidemiologic transition, whereas men were in the middle phase.
Highlights
In high-income countries, persons of high socioeconomic status (SES) have a lower cardiovascular risk
When comparing the cardiovascular risk factors according to sex, women showed higher prevalences of diabetes (2.5%), low high-density lipoprotein (HDL)-cholesterol (45.1%), high fibrinogen (15.5%), high caloric intake (25.3%), smoking (20.9%), and sedentarism (54.3%), whereas men presented higher prevalences of high HOMA IR (22.5%), high triglycerides (16.3%), high blood pressure (40.8%), and metabolic syndrome (17.8%)
The young adult women belonging to the low family income group had higher prevalences of insulin resistance (HOMA IR index — 19.8%; p = 0.039), low HDL-cholesterol (52.6%; p < 0.001), total obesity (14.6%; p = 0.003), abdominal obesity (18.5%; p < 0.001), metabolic syndrome (MS) (7.7%, p = 0.021), and high caloric intake (27.4%; p = 0.023), as well as a higher prevalence of sedentarism (58.5%; p < 0.001)
Summary
In high-income countries, persons of high socioeconomic status (SES) have a lower cardiovascular risk. Cardiovascular risk factors (hypertension, sedentary lifestyle, smoking, low highdensity lipoprotein (HDL)-cholesterol, high low-density lipoprotein (LDL)-cholesterol, high fibrinogen, insulin resistance, diabetes, abdominal and total obesity, and metabolic syndrome) were evaluated according to family income. High-income men showed lower prevalences of low HDL-cholesterol (PR = 0.73) and sedentarism (PR = 0.81) (p < 0.05) These results may be explained by the fact that high-income women pay more attention to healthy habits and those with the lowest family income are least likely to access health services resources and treatments. Researches conducted in high-income countries have demonstrated that high-income persons have a lower cardiovascular risk, whereas low-income ones present a higher cardiovascular risk These differences in cardiovascular risk factors between the wealthy and the poor are attributed to the epidemiologic transition[4,5,6]
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