Social gradients in cardiovascular risk factors and symptoms of Swedish men and women: the Göteborg MONICA Study 1995.
BACKGROUND
Even though coronary mortality in middle and old age is decreasing, social gradients may be increasing; but they need not necessarily be the same for men and women. In order to develop efficient preventive strategies more knowledge of the current distributions of risk factors both for men and for women is needed.


OBJECTIVE
To investigate and to compare the socio-economic gradients for coronary risk factors of men and women.


METHODS
A cross-sectional study.


METHODS
We studied 686 men and 825 women aged 25-64 years from a random population sample. Socio-economic status (SES) was classified according to the occupation-based Swedish Socio-economic Index.


RESULTS
For women, high SES was associated with lower levels of total and low-density lipoprotein cholesterol, lower serum levels of triglycerides, higher levels of high-density lipoprotein cholesterol and lower blood pressure. For men, no relation between occupational status and levels of lipids and blood pressure was found. Obesity was associated with low SES both for men and for women. Socioeconomic differences in smoking habits were more pronounced for women than they were for men. The proportion of post-menopausal women was higher among the unskilled workers, despite there being no differences in age. Optimal risk factor status (non-smoker, total cholesterol level < 5 mmol/l, blood pressure < 140/90 mmHg without treatment and body mass index < 25 kg/m2) was unusual both among men and among women, but 34% of the higher officials among the women had optimal risk factor status, compared with 10% of the unskilled workers. Corresponding values for the men were 16 and 9% (P for interaction 0.09). The relation between low SES and level of low-density lipoprotein cholesterol was independent of smoking, post-menopausal state, use of oestrogen and waist:hip ratio (P = 0.04) and so was the relation between systolic blood pressure and low SES (P = 0.0003).


CONCLUSIONS
In Sweden, low SES exerts a stronger adverse influence on cardiovascular risk factors of women than it does on those of men.
Manhem
K
K
Section of Preventive Cardiology, Sahlgrenska University Hospital/Ostra, SE-41685 Göteborg, Sweden.
Dotevall
A
A
Wilhelmsen
L
L
Rosengren
A
A
D000328:Adult; D017677:Age Distribution; D003327:Coronary Disease / Q000175:diagnosis* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011159:Population Surveillance; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D012923:Social Class; D012959:Socioeconomic Factors; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology