Social status and cardiovascular disease: a Mediterranean case. Results from the Italian Progetto CUORE cohort study

BMC Public Health

Research Article

Diego Vanuzzo¹  Lorenza Pilotto¹  Marco M Ferrario²  Salvatore Panico³  Chiara Donfrancesco⁴  Luigi Palmieri⁴  Simona Giampaoli⁴  Giancarlo Cesana⁵  Michele A Riva⁵  Carla Fornari⁵ 

[1] Centro per la Prevenzione Cardiovascolare, Azienda Socio-Sanitaria 4 Medio Friuli and Agenzia Regionale della Sanità, Udine, Italy;Department of Clinical and Biological Science, University of Insubria, Varese, Italy;Department of Clinical and Experimental Medicine, University Federico II of Naples, Naples, Italy;Laboratory of Epidemiology and Biostatistics, National Institute of Public Health, Rome, Italy;Research Centre on Public Health, Department of Clinical and Preventive Medicine, University of Milano-Bicocca, Monza, Italy;

关键词: Marital Status;    Educational Level;    Cardiovascular Risk Factor;    Mediterranean Diet;    Major Cardiovascular Risk Factor;   

DOI  :  10.1186/1471-2458-10-574

 received in 2010-03-10, accepted in 2010-09-24,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundSocial factors could offer useful information for planning prevention strategy for cardiovascular diseases. This analysis aims to explore the relationship between education, marital status and major cardiovascular risk factors and to evaluate the role of social status indicators in predicting cardiovascular events and deaths in several Italian cohorts.MethodsThe population is representative of Italy, where the incidence of the disease is low. Data from the Progetto CUORE, a prospective study of cohorts enrolled between 1983-1997, were used; 7520 men and 13127 women aged 35-69 years free of previous cardiovascular events and followed for an average of 11 years. Educational level and marital status were used as the main indicators of social status.ResultsAbout 70% of the studied population had a low or medium level of education (less than high school) and more than 80% was married or cohabitating. There was an inverse relationship between educational level and major cardiovascular risk factors in both genders. Significantly higher major cardiovascular risk factors were detected in married or cohabitating women, with the exception of smoking. Cardiovascular risk score was lower in married or cohabitating men. No relationship between incidence of cardiac events and the two social status indicators was observed. Cardiovascular case-fatality was significantly higher in men who were not married and not cohabitating (HR 3.20, 95%CI: 2.21-4.64). The higher cardiovascular risk observed in those with a low level of education deserves careful attention even if during the follow-up it did not seem to determine an increase of cardiac events.ConclusionsPreventive interventions on cardiovascular risk should be addressed mostly to people with less education. Cardiovascular risk score and case-fatality resulted higher in men living alone while cardiovascular factors were higher in women married or cohabitating. Such gender differences seem peculiar of our population and require further research on unexpected cultural and behavioural influences.

【 授权许可】

Unknown   
© Fornari et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.