Socio-economic status in relation to risk factors associated with cardiovascular disease, in healthy individuals from the ATTICA study.
BACKGROUND
Social status has been related with the prevalence and incidence of cardiovascular disease. The aim of this study is to investigate the relationships between socio-economic status (SES) and clinical and biochemical factors related to coronary heart disease, in a sample of cardiovascular disease-free men and women.


METHODS
Cross-sectional survey.


METHODS
During 2001-2002, 1514 men (20-87 years old) and 1528 women (20-89 years old) from the Attica region (Greece) were randomly enrolled into the study. Trends in established and emerging cardiovascular risk factors were examined across the participants' socio-economic status. A special index was developed (years of school by annual income) and three socio-economic classes were created.


RESULTS
An inverse relationship was found regarding all lipids and glucose levels across the tertiles of the SES index. An inverse association was observed between body mass index, waist-to-hip ratio and SES in men, but not in women. Furthermore, compared to the lowest tertile, individuals who were classified in the highest SES tertile had lower levels of C-reactive protein, fibrinogen, homocysteine, tumour necrosis factor-alpha, interleukin-6 levels and white blood cell counts, even after adjusting for various potential confounders. Finally, a considerable proportion of men and women reported lack of health knowledge and education.


CONCLUSIONS
An inverse association between SES and factors related to cardiovascular risk exists, but the causal pathway itself requires more detailed explanation before the social status can have explanatory power.
Panagiotakos
Demosthenes B
DB
First Cardiology Department, School of Medicine, University of Athens, Athens, Greece. D.b.Panagiotakos@usa.net
Pitsavos
Christos
C
Manios
Yannis
Y
Polychronopoulos
Evangelos
E
Chrysohoou
Christina A
CA
Stefanadis
Christodoulos
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose; D002097:C-Reactive Protein; D002318:Cardiovascular Diseases / Q000191:economics* / Q000503:physiopathology*; D015331:Cohort Studies; D015986:Confounding Factors, Epidemiologic; D016207:Cytokines / Q000097:blood; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D012923:Social Class
D015415:Biomarkers; D001786:Blood Glucose; D016207:Cytokines; D002097:C-Reactive Protein