Is different the prevalence of cardiovascular risk factors in the different economic levels ?

Authors Reza Sharif-Zadeh 1, Toba Kazemi 2, Hossein Beydokhti 3 1- epidemiologist 2- associate professor of Cardiology 3--Master of Library and Information Science Birjand Cardiovascular Research Center(BCRC)

Introduction Cardiovascular diseasesare one of the most important causes of death in developing and industrial countries. It has been predicted that up to 2020 Among cardiovascular diseases,coronary artery disease(CAD) is more important. the Framingham Heart Study, North Carolina Heart Study, European Youth Heart Study, Minnesota Heart Disease and Stroke Prevention, The Monica study.

Introduction-continue There are several factors contributing to‍‍‍ CAD that hypertension, dyslipidemia, diabetes, immobility, smoking and obesity are modifiable ones. fortunately, effective program have been taken to identify cardiac risk factors situations in IRAN including Isfahan healthy heart program, Tehran Lipid &Gloucose study,,preventive program in Ghazvin and zanjan and other similar plans throughout the country.

The socioeconomic status (SES) is one of the strongest predictors of morbidity and mortality experience at population level. SES is a multidimensional and complex phenomenon consisting of financial, occupational, and educational components

The aim of this study Is different the prevalence of cardiovascular risk factors in the different economic levels?  Cardiac risk factors in low socioeconomic levels  Cardiac risk factors in high socioeconomic levels  comparsion ofCardiac risk factors in these 2 socioeconomic levels

Methods  This analytical descriptive study has been done in Birjand, in 2 different economic class  with the cooperation of The Imam Khomeini Relief Foundation South Khorasan,  The “healthy life study in IKRF coverage group”, has been done in Birjand  1- low social class (The Imam Khomeini Relief Foundation (IKRF) people (1008 subject)  2-high social class “Birjand Heart Study in employee”, in Birjand.( 634 subject)

Methods  The questionnaire has been filled by interviewing, physical examination and lab data.In standard situation, data related to the patients' past medical history, height, weight, waist circumference, hip circumference, fasting blood pressure & lipid were recorded.  Data analysed by SPSS 15/5 software  The Imam Khomeini Relief foundation, as the greatest supportive organization, supports more than 4/5 million of the deprived and the needy people in the country.  employees of government department  s

Results

sex

HTN

DM

DYSLIPIDEMIA

SMOKING

Overweight & Obesity

Percentage of dyslipidemia

Comparsion of risk factors in 2 groups

Socioeconomic status and CAD The socioeconomic status (SES) is one of the strongest predictors of morbidity and mortality. SES is a phenomenon consisting of financial, occupational, and educational components. In our study; Smoking, DLP(LDL,chol),HTN DM,Obesity,DLP(TG,HDL)

The association of cardiovascular disease (CVD) risk and mortality with SES has been proved many Western countries.

Socioeconomic status and obesity In a systematic review of SES and obesity including over 300 studies, McLaren concluded that the social gradient found in women was frequently absent in men, for whom many results were non- significant or indicated a reversed gradient. In the CARLA Study, male participants with middle education, occupational grade or income had the same or even higher risk of being obese than men of the lowest category Mclaren. Epidemiol Rev 2007,29:29-48

Association of socioeconomic profiles with cardiovascular risk factors in Iran: the Isfahan Healthy Heart Program The population studied comprised 12,514 subjects. In the current study, the three components of SES, i.e., education, occupation, and income were associated with life style behaviors and CVD risk factors. smoking in men:higher education, protective factor smoking in women;it increased the risk of smoking Int J Public Health (2011), Isfahan Healthy Heart Program

 The other risk factors increased with education especially in men.  Higher income level increased the OR of CVD risk factors.  The employed individuals had higher serum lipid level and body mass index than unemployed individual.  Education level was the strongest associated factor. the Isfahan Healthy Heart Program

Bulletin of the World Health Organization, 2000 In 1996, a behavioural risk factor survey was carried out in Tianjin, the third largest city in China. A sample of 4000 people aged 15–69 years. Educational level seemed to be the most important measure socioeconomic indicators in relation to the cardiovascular risk factors in the study population. People with lower socioeconomic status had higher levels of cardiovascular risk factors. The association between socioeconomic status and cardiovascular risk factors was more consistent among women than men.

ارتباط عوامل اجتماعي اقتصادي در افراد كمتر از 45سال،موردي شاهدي.بيمارستان قلب شهيد رجايي  In tehran,100 patients with premature MI & 100 control  Negative association between education & cAD.  low income is a risk factor in this study مجله دانشكده بهداشت و انستيتو تحقيقات بهداشتي1388

Socioeconomic position, gender, health behaviours and biomarkers. Australia This study uses data collected as part of the Australian Diabetes, Obesity and Lifestyle study, a national population-based cross-sectional study of 11,247 adults aged _25 years conducted in They conclude that low socio-economic position is more consistently associated with a worse profile of biomarkers for CVD and diabetes for women. Social Science & Medicine 71 (2010)

Socioeconomic status and coronary heart disease risk factor trends. The Minnesota heart survey o The Minnesota Heart Survey includes measurement of CHD risk factors and behaviors in population-based samples of 7782 aged 25 to 74 years in 1980 to o Education was significantly and inversely related to HTN, smoking, BMI, for both men and women. o Serum cholesterol was inversely related to education in women but not in men o Low-education groups continue to have the highest level of risk characteristics and the highest expected CHD rates. Circulation 1993

Socioeconomic status and the prevalence of coronary heart disease risk factors.  India, in particular, has a high burden of CHD  healthy sample of 440 men and 210 women  In men, a significant positive rank correlation was between SES and chol, TG, systolic and diastolic BP, and BMI,  women, the same trend was found only with chol, TG, skinfold ratio and age.  In both sexes, the prevalence of hypercholesterolemia, hypertriglyceridemia and sedentary life style increased among higher SES groups (P < 0.05).  The results demonstrate that higher SES groups have greater prevalence of CHD risk factors than lower SES groups. Asia Pacific J Clin Nutr 2002

CONCLUSION  Socioeconomic factors, has at least same association with cardiac risk factors.  In IKRF;the most pravalent risk factors was DLP,Overweight,HTN,DM THE PREVENTIVE PROGRAM IS NESSESARY IN IRAN IN ALL GROUPS