ARYA Atherosclerosis Journal

Current Issue

By Issue

By Author

By Subject

Author Index

Keyword Index

About Journal

Aims and Scope

Editorial Board

Publication Ethics

Indexing and Abstracting

Related Links

FAQ

Peer Review Process

Journal Metrics

News

Socioeconomic status, cardiac risk factors, and cardiovascular disease: A novel approach to determination of this association

Document Type : Original Article(s)

Authors

1 Assistant Professor, Pharmaceutical Management and Economic Research Center AND Department of Pharmacoeconomics and Pharmaceutical Administration, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

2 Professor, Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

3 PhD Candidate, Students’ Scientific Research Center AND Department of Pharmacoeconomics and Pharmaceutical Administration, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

Abstract

BACKGROUND: Socioeconomic inequality is one of the important issues in cardiovascular diseases (CVDs). The aim of this study was to investigate the distribution and relation between selected cardiac risk factors, type of CVD, and the socioeconomic status (SES) in the hospitalized patients with heart disease in Isfahan, Iran.METHODS: This analytical and cross-sectional study was conducted in Isfahan in 2013. The population consisted of all patients with CVD admitted to the public and private hospitals. The sample size was 721. Data collection was conducted through one researcher-made questionnaire with three sections: demographic, disease, and SES questionnaires. To determine the SES of the patients, the indicators of income, housing status, occupation, family size, and education were used. Data analysis was conducted in two statistical levels of descriptive and inferential.RESULTS: 69.1% of the patients were placed in the poor status, and there was no wealthy status within the subjects. The five most frequent CVDs were chronic ischemia, unstable angina, arrhythmia, congestive heart failure (CHF), and acute myocardial infarction (MI), respectively. The three highest frequent risk factors in the patients were hypertension (HTN) (47.2%), diabetes (33.6%), and hyperlipidemia (32.6%). Regression analysis of the risk factors and the type of heart disease on the SES revealed that there were statistically significant differences between patients who were smokers (P = 0.030) and those who had valve disease (P = 0.010), adjusted for age, gender, and marital status.CONCLUSION: Our findings showed that the frequency of CVD risk factors were higher in lower SES groups and thus SES can be a strong predictor for the occurrence of the CVD risk factors as well as the CVDs. 

Keywords

References
  1. Joshi R, Jan S, Wu Y, MacMahon S. Global inequalities in access to cardiovascular health care: Our greatest challenge. J Am Coll Cardiol 2008; 52(23): 1817-25.
  2. Blas E, Kurup AS. Equity, social determinants and public health programmes. Geneva, Switzerland: World Health Organization; 2010.
  3. Sturm R, Gresenz CR. Relations of income inequality and family income to chronic medical conditions and mental health disorders: National survey. BMJ 2002; 324(7328): 20-3.
  4. Morgenstern H. The changing association between social status and coronary heart disease in a rural population. Soc Sci Med Med Psychol Med Sociol 1980; 14A(3): 191-201.
  5. Mackenbach JP, Kunst AE, Cavelaars AE, Groenhof F, Geurts JJ. Socioeconomic inequalities in morbidity and mortality in Western Europe. The EU Working Group on Socioeconomic Inequalities in Health. Lancet 1997; 349(9066): 1655-9.
  6. Kunst AE, del Rios M, Groenhof F, Mackenbach JP. Socioeconomic inequalities in stroke mortality among middle-aged men: An international overview. European Union Working Group on Socioeconomic Inequalities in Health. Stroke 1998; 29(11): 2285-91.
  7. Ickovics JR, Viscoli CM, Horwitz RI. Functional recovery after myocardial infarction in men: The independent effects of social class. Ann Intern Med 1997; 127(7): 518-25.
  8. Greenwood D, Packham C, Muir K, Madeley R. How do economic status and social support influence survival after initial recovery from acute myocardial infarction? Soc Sci Med 1995; 40(5): 639-47.
  9. Mendis S, Abegunde D, Yusuf S, Ebrahim S, Shaper G, Ghannem H, et al. WHO study on prevention of recurrences of myocardial infarction and stroke (WHO-PREMISE). Bull World Health Organ 2005; 83(11): 820-9.
  10. Keskimaki I, Koskinen S, Salinto M, Aro S. Socioeconomic and gender inequities in access to coronary artery bypass grafting in Finland. Eur J Public Health 1997; 7(4): 392-7.
  11. Arrich J, Lalouschek W, Mullner M. Influence of socioeconomic status on mortality after stroke: Retrospective cohort study. Stroke 2005; 36(2): 310-4.
  12. Petrelli A, Gnavi R, Marinacci C, Costa G. Socioeconomic inequalities in coronary heart disease in Italy: A multilevel population-based study. Soc Sci Med 2006; 63(2): 446-56.
  13. Hawkins NM, Jhund PS, McMurray JJ, Capewell S. Heart failure and socioeconomic status: Accumulating evidence of inequality. Eur J Heart Fail 2012; 14(2): 138-46.
  14. Davari M, Khorasani E, Bakhshizade Z, Jafarian Jazi M, Ghaffari Darab M, Maracy MR. Measuring equity in access to pharmaceutical services using concentration curve; Model development. Iran J Pharm Res 2015; 14(4): 1317-26.
  15. Davari M, Khorasani E, Bakhshizade Z, Jafarian Jazi M, Ghaffari Darab M, Maracy MR. A single model for determining socioeconomic status in health studies; a crucial step to make the results more comparable. Value Health 2014; 17(7): A730.
  16. Kavosi Z, Rashidian A, Pourmalek F, Majdzadeh R, Pourreza A, Mohammad K, et al. Measuring household exposure to catastrophic health care expenditures: A longitudinal study in zone 17 of Tehran. Hakim Health Sys Res 2009; 12(2): 38-47. [In Persian].
  17. Davari M, Maracy M, Ghorashi Z, Mokhtari M. The Relationship between Socioeconomic Status and the Prevalence of Elective Cesarean Section in Nulliparous Women in Niknafs Teaching Center, Rafsanjan, Iran. Health Info Manage 2012; 8(7): 958-65. [In Persian].
  18. Sundquist K, Malmstrom M, Johansson SE. Neighbourhood deprivation and incidence of coronary heart disease: A multilevel study of 2.6 million women and men in Sweden. J Epidemiol Community Health 2004; 58(1): 71-7.
  19. Stewart S, Murphy NF, McMurray JJ, Jhund P, Hart CL, Hole D. Effect of socioeconomic deprivation on the population risk of incident heart failure hospitalisation: An analysis of the Renfrew/Paisley Study. Eur J Heart Fail 2006; 8(8): 856-63.
  20. Roberts CB, Couper DJ, Chang PP, James SA, Rosamond WD, Heiss G. Influence of life-course socioeconomic position on incident heart failure in blacks and whites: The Atherosclerosis Risk in Communities Study. Am J Epidemiol 2010; 172(6): 717-27.
  21. Gottdiener JS, Arnold AM, Aurigemma GP, Polak JF, Tracy RP, Kitzman DW, et al. Predictors of congestive heart failure in the elderly: The Cardiovascular Health Study. J Am Coll Cardiol 2000; 35(6): 1628-37.
  22. Borne Y, Engstrom G, Essen B, Sundquist J, Hedblad B. Country of birth and risk of hospitalization due to heart failure: A Swedish population-based cohort study. Eur J Epidemiol 2011; 26(4): 275-83.
  23. Christensen S, Mogelvang R, Heitmann M, Prescott E. Level of education and risk of heart failure: A prospective cohort study with echocardiography evaluation. Eur Heart J 2011; 32(4): 450-8.
  24. Matthews KA, Kiefe CI, Lewis CE, Liu K, Sidney S, Yunis C. Socioeconomic trajectories and incident hypertension in a biracial cohort of young adults. Hypertension 2002; 39(3): 772-6.
  25. Grotto I, Huerta M, Grossman E, Sharabi Y. Relative impact of socioeconomic status on blood pressure lessons from a large-scale survey of young adults. Am J Hypertens 2007; 20(11): 1140-5.
  26. Jacobsen BK, Thelle DS. Risk factors for coronary heart disease and level of education. The Tromso Heart Study. Am J Epidemiol 1988; 127(5): 923-32.
  27. Millar WJ, Wigle DT. Socioeconomic disparities in risk factors for cardiovascular disease. CMAJ 1986; 134(2): 127-32.
  28. Kanjilal S, Gregg EW, Cheng YJ, Zhang P, Nelson DE, Mensah G, et al. Socioeconomic status and trends in disparities in 4 major risk factors for cardiovascular disease among US adults, 1971-2002. Arch Intern Med 2006; 166(21): 2348-55.
  29. Galobardes B, Costanza MC, Bernstein MS, Delhumeau C, Morabia A. Trends in risk factors for lifestyle-related diseases by socioeconomic position in Geneva, Switzerland, 1993-2000: Health inequalities persist. Am J Public Health 2003; 93(8): 1302-9.
  30. Strik JJ, Denollet J, Lousberg R, Honig A. Comparing symptoms of depression and anxiety as predictors of cardiac events and increased health care consumption after myocardial infarction. J Am Coll Cardiol 2003; 42(10): 1801-7.
  31. Savu A, Schopflocher D, Scholnick B, Kaul P. The intersection of health and wealth: Association between personal bankruptcy and myocardial infarction rates in Canada. BMC Public Health 2016; 16: 31.
  32. Shimony A, Zahger D, Ilia R, Shalev A, Cafri C. Impact of the community's socioeconomic status on characteristics and outcomes of patients undergoing percutaneous coronary intervention. Int J Cardiol 2010; 144(3): 379-82.
  33. Baghaei R, Parizad N, Alinejad V, Khademvatan K. Epidemiological study of patients with acute myocardial infarction In Seyyed Al Shohada Hospital in Urmia. Urmia Med J 2013; 24(10): 763-70. [In Persian].
  34. Barzigar A, Manzar HA. Evaluation of risk factors associated with systemic disease in 1000 patients of acute myocardial infarction. J Shahid Sadoughi Univ Med Sci Health Serv1997; 5: 28-35. [In Persian].
  35. Hatmi ZN, Tahvildari S, Gafarzadeh Motlag A, Sabouri Kashani A. Prevalence of coronary artery disease risk factors in Iran: A population based survey. BMC Cardiovasc Disord 2007; 7: 32.
  36. Hetemaa T, Keskimaki I, Manderbacka K, Leyland AH, Koskinen S. How did the recent increase in the supply of coronary operations in Finland affect socioeconomic and gender equity in their use? J Epidemiol Community Health 2003; 57(3): 178-85.
  37. Dabagh A, Sarafzadegan N, Banifatemi V, Habibi Hr, Rafiei M. Costs of therapeutic modalities of cardiovascular patients in Isfahan University hospitals. Hakim Res J 2003; 6(2): 19-25. [In Persian].
  38. Vahidi R, Saadati M. Determining the distribution of effective factors on out of pocket payment (formal and informal) in hospitalized cardiac patientsof Shahid Madani hospital and its side effects on the patient or companions-Iran-Tabriz 2010. Hospital 2013; 11(4): 45-52. [In Persian].
  39. Baghaei R, Parizad N, Alinejad V, Khademvatan K. Epidemiological study of patients with acute myocardial infarction in seyyed al Shohada Hospital in Urmia. Urmia Med J 2013; 24(10): 763-70. [In Persian].
  40. Moeini M, Mokhtari H, Adibi F, Lotfizadeh N, Moeini M. The prevalence of hypertension among the elderly in patients in Al-Zahra Hospital, Isfahan, Iran. ARYA Atheroscler 2012; 8(1): 1-4.
  41. Veghari G, Sedaghat M, Maghsodlo S, Banihashem S, Moharloei P, Angizeh A, et al. Impact of literacy on the prevalence, awareness, treatment and control of hypertension in adults in Golestan Province (northern Iran). Caspian J Intern Med 2013; 4(1): 580-4.
  42. Meysamie A, Ghaletaki R, Zhand N, Abbasi M. Cigarette smoking in Iran. Iran J Public Health 2012; 41(2): 1-14.
ARYA Atherosclerosis Journal
Volume 15, Issue 6 - Serial Number 6
November and December 2019
Pages 260-266
Files
Share
How to cite
Statistics