CCCardiol CroatCardiologia CroaticaCardiol. Croat.1848-543X1848-5448Croatian Cardiac SocietyCC 2022 17_9-10_26810.15836/ccar2022.268Extended AbstractRegistries and observational surveysSocioeconomic determinants of cardiovascular disease – results of the European Health Interview Survey 2019 Surveyhttps://orcid.org/0000-0002-2292-2167ČukeljPetra*https://orcid.org/0000-0002-4623-828XKraljVericahttps://orcid.org/0000-0003-4950-7083Korda OrlovićKarmenhttps://orcid.org/0000-0002-0735-2127GrahovacIvanaCroatian Institute of Public Health, Zagreb, CroatiaADDRESS FOR CORRESPONDENCE: Petra Čukelj, Hrvatski zavod za javno zdravstvo, Rockefellerova 7, HR-10000 Zagreb, Croatia. / Phone: +385-99-5929-903 / E-mail: petra.cukelj@hzjz.hr112022179-1026826804112022101120222022Croatian Cardiac SocietyKEYWORDS: socioeconomic inequalitieseducationincomerisk factors
Introduction: We know from the literature that socioeconomic variables, such as education and income level, are related to cardiovascular risks and outcomes (1). Our goal was to explore possible differences in prevalence of risk factors for cardiovascular disease (CVD), stroke, myocardial infarction (MI), coronary heart disease (CHD) and raised lipid levels in older people (65+ years of age) population in Croatia, depending on their education and income level.
Methods: We used the data from the European Health Interview Survey (EHIS) conducted in 2019. Prevalence of MI, CHD, hypertension, raised blood lipids, overweight and obesity and smoking were calculated, stratified by income groups and education level. EHIS differentiates 5 quintiles/income groups; for the purpose of this research, we combined quintile 1 and 2 into “lower income” group, and quintiles 4 and 5 into “higher income” group. Education was stratified according to ISCED 2011 classification into lower levels (primary school or less), middle level (secondary school) and high level (tertiary education).
Results: Older people with lower income have higher prevalence of stroke, MI and CHD, while prevalence of high lipid levels is higher in people with higher income. Overweight is more prevalent in higher income group, while opposite is found for obesity and smoking. Stroke and raised lipid levels are more prevalent in the low education group, MI in high education group, while no difference is seen in CHD. Smoking and obesity are also higher in people with lower education levels. Results are presented in Table 1.
Percentages of cardiovascular disease, smoking, overweight and obesity by income and education levels in people aged 65+, results of the European Health Interview Survey 2019 survey in Croatia.
Income
Education level
%
Low income(Q1-2)
High income(Q4-5)
Low
Middle
High
Stroke
6.9
5.1
8.0
7.9
4.5
Myocardial infraction
6.7
6.3
6.8
9.2
10.0
Coronary heart disease
20.6
18.3
21.2
18.2
21.5
Raised lipid levels
27.2
34.6
34.5
32.4
31.4
Daily smokers
13.1
10.2
6.2
13.7
16.2
BMI >25
72.6
78.8
74.5
75.0
71.7
BMI >30
31.0
29.0
33.1
27.7
17.4
BMI = body mass index; Q = quintile
Conclusion: From a simple descriptive analysis, we can see a higher prevalence of some CVD risk factors (obesity and smoking) in people with lower income and lower levels of education in Croatia. Similarly, people with lower levels of education and income have higher self-reported prevalence of stroke and raised lipid levels. More complex analysis and research is needed to establish the relationship and interaction between these variables and targeting these higher risk groups in prevention activities and screening for CVD risk factors could reduce the inequalities.
LITERATURESchultzWMKelliHMLiskoJCVargheseTShenJSandesaraPSocioeconomic Status and Cardiovascular Outcomes: Challenges and Interventions.Circulation. 2018 May 15;137(20):2166–78. 10.1161/CIRCULATIONAHA.117.02965229760227