Coronary disease & ACSCohort study
Cumulative social disadvantage and cardiovascular disease burden and mortality
- Prospective cohort study
- cross-sectional and longitudinal analyses
Authors' conclusion
Despite universal healthcare access, cumulative social disadvantage remains associated with higher risk of CVD and mortality. Dimensions of education and occupation, but not household net income, are associated with outcomes of interest.
Study context
- Population
- General population aged 35 to 74 years, Gutenberg Health Study, baseline 2007 to 2012
- Participants
- 15,010 participants
- Exposure
- Low socioeconomic status (SES) vs high SES
- Outcome
- CVD (composite of AF, CAD, MI, stroke, chronic HF, PAD and/or VTE) risk and mortality
Main finding
Prevalent CVD · baseline
Odds ratio
1.19
95% CI 1.01–1.40
Low SES vs High SES
OR 1.19 (95% CI 1.01–1.40)
As reported in the abstract
- Subjects with prevalent cardiovascular disease (CVD) had lower SES sum, education, occupation and household net-income scores
- all P < 0.0001
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| CV mortality · 5-year follow-up | HR 5.36 (CI 2.24–12.82) | |
| All-cause mortality · 5-year follow-up | HR 2.23 (CI 1.51–3.31) | |
| Incident CVD · 10-year follow-up | OR 1.68 (CI 1.12–2.47) | |
| All-cause mortality · 10-year follow-up | HR 1.86 (CI 1.55–2.24) | |
| 0.050.21520Ratio (log scale) |
Burden attributable to low SES
- Disability-adjusted life years per 1000 people
- 451.45
- Years lived with disability per 1000
- 373.41
- Years of life lost per 1000
- 78.03
- CVD cases per 1000 people per year
- 11
- CVD deaths per 1000 people per year
- 3.47
- Population attributable fraction for CVD incidence after 5 years
- 4%
SES dimensions
- Education and occupation scores more strongly related to CVD and death than household net-income score
Original publication
Cumulative social disadvantage and cardiovascular disease burden and mortality. Eur J Prev Cardiol. Published 18 September 2023. doi:10.1093/eurjpc/zwad264
Summarised from the published abstract; every number is checked against it