Cor Vasa 2008, 50(7-8):309-312 | DOI: 10.33678/cor.2008.105
The role of social and economic factors in the prevention of cardiovascular disease
- Pracoviště preventivní kardiologie, Institut klinické a experimentální medicíny, Praha, Česká republika
In the industrialized nations, a lower socioeconomic status (SES) is associated with higher cardiovascular (CV) morbidity and mortality as a result of a higher prevalence of smoking, overweight and obesity, lower physical activity, higher blood pressure, more frequent hyperlipidemia and diabetes, adverse psychosocial factors (social exclusion, stress, depression, anxiousness, hostility) and poorer patients' compliance with physician's instructions regarding prevention and treatment among individuals of lower social standing. Conventional CV risk factors will explain about half of the social gradient in the coronary heart disease (CHD) risk; CV prevention among individuals of lower SES is less successful and requires modified strategies and specific programs. Unlike intervention of conventional risk factors, that of psychosocial factors fails to reduce CV morbidity and mortality significantly. The SCORE tables of CV risk do not take into account SES and underestimate the risk with individuals of low social standing. It is just these individuals and the disadvantaged ones, with a low level of education, and those resident in problem-ridden areas and regions that preventive cardiology should give increased attention to.
Keywords: Cardiovascular prevention; Social and economic factors; Risk factors; Psychosocial factors; Socio-economic status
Published: July 1, 2008 Show citation
References
- British Heart Foundation. 2007 Coronary Heart Disease Statistics. www.heartstats.org
- Bruthans J. Zpráva o vývoji kardiovaskulárních onemocnění v České republice po roce 1989. Praha: Galén, 2000.
- Fawcett J, Blakely T. Cancer is overtaking cardiovascular disease as the main driver of socioeconomic inequalities in mortality: New Zealand (1981-99). J Epidemiol Community Health 2007;61:59-66.
Go to original source...
Go to PubMed...
- Marmot MG, Smith GD, Stansfeld S, et al. Health inequalities among British civil servants: the Whitehall II study. Lancet 1991;337:1387-93.
Go to original source...
Go to PubMed...
- Lunch JW, Kaplan GA, Cohen RD, Tuomiletho J, Salonen JT. Do cardiovascular risk factors explain the relation between socioeconomic status, risk of all cause mortality, cardiovascular mortality and acute myocardial infarction? Am J Epidemiol 1996;144:934-42.
Go to original source...
Go to PubMed...
- Wamala SP, Mittleman MA, Schenck-Gustafsson K, Orth-Gomer K. Potential explanations for the educational gradient in coronary heart disease: a population based case control study of Swedish women. Am J Public Health 1999;89:315-21.
Go to original source...
Go to PubMed...
- De Henauw S, De Bacquer D, de Smet P, Kornitzer M, De Backer G. Trends in coronary heart disease in two Belgian areas: results from the MONICA Ghent-Charleroi study. J Epidemiol Community Health 1999;52:89-98.
Go to original source...
Go to PubMed...
- Šimon J, Cajzl L, Křižanovská M, et al. Occupation and education in relation to risk factors of ischaemic heart disease in the male industrial population. Cor Vasa 1986;28:167-76.
- Bobak M, Hertzman C, Škodova Z, Marmot M. Socioeconomic status and cardiovascular risk factors in the Czech Republic. Int J Epidemiol 1999;28:46-52.
Go to original source...
Go to PubMed...
- Lawlor DA, Batty GD, Morton SMB, Clark H, Macintyre S, Leon DA. Childhood socioeconomic position, educational attainment and adult cardiovascular risk factors: the Aberdeen children of the 1950s cohort study. Am J Publ Health 2005;95:1245-51.
Go to original source...
Go to PubMed...
- Marmot MG. Social differentials in mortality: The Whitehall studies. Adult mortality in developed countries: from description to explanation. Lopez A, Castelli G, Valkonen T, ed. Oxford: Claredon Press, 1995.
- Graham I, Atar D, Borch-Johnsen K, et al. European guidelines on cardiovascular disease prevention in clinical practice. Fourth joint task force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical praktice. Eur J Cardiovasc Prev Rehab 2007;14 (Suppl 2):S1-S113.
Go to original source...
Go to PubMed...
- Woodward M, Brindle P, Tunstall-Pedoe H. Adding social deprivation and family history to cardiovascular risk assessment: the ASSIGN score from the Scottish Heart Health Extended Cohort (SHHEC). Heart 2007;93:172-6.
Go to original source...
Go to PubMed...