title: Social burden and lifestyle in adults with congenital heart disease.
abstract: We aimed to evaluate how the presence and severity of congenital heart disease (CHD) influence social life and lifestyle in adult patients. A random sample (n = 1,496) from the CONgenital CORvitia (n = 11,047), the Dutch national registry of adult patients with CHD, completed a questionnaire on educational attainment, employment and marital statuses, and lifestyle (response 76%). The Utrecht Health Project provided a large reference group (n = 6,810) of unaffected subjects. Logistic regression models were used for subgroup analyses and to adjust for age, gender, and socioeconomic status where appropriate. Of all patients 51.5% were men (median age 39 years, interquartile range 29 to 51) with mild (46%), moderate (44%), and severe (10%) CHD. Young (<40-year-old) patients with CHD were more likely to have achieved a lower education (adjusted odds ratios [ORs] 1.6 for men and 1.9 for women, p <0.05 for the 2 comparisons), significantly more often unemployed (adjusted ORs 5.9 and 2.0 for men and women, respectively), and less likely to be in a relationship compared to the reference group (adjusted ORs 8.5 for men and 4.5 for women). These poorer outcomes were seen in all severity groups. Overall, the CHD population smoked less (adjusted OR 0.5, p <0.05), had more sports participation (adjusted OR 1.2, p <0.05), and had less obesity (adjusted OR 0.7, p <0.05) than the reference group. In conclusion, there was a substantial social disadvantage in adult patients with CHD, which was seen in all severity groups and primarily in young men. In contrast, adults with CHD had healthier lifestyles compared to the reference group.
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: A Carla
authors.initials: AC
authors.lastname: Zomer
authors.forename: Ilonca
authors.initials: I
authors.lastname: Vaartjes
authors.forename: Cuno S P
authors.initials: CS
authors.lastname: Uiterwaal
authors.forename: Enno T
authors.initials: ET
authors.lastname: van der Velde
authors.forename: Gert-Jan T
authors.initials: GJ
authors.lastname: Sieswerda
authors.forename: Elly M C
authors.initials: EM
authors.lastname: Wajon
authors.forename: Koos
authors.initials: K
authors.lastname: Plomp
authors.forename: Paul F M
authors.initials: PF
authors.lastname: van Bergen
authors.forename: Carianne L
authors.initials: CL
authors.lastname: Verheugt
authors.forename: Eva
authors.initials: E
authors.lastname: Krivka
authors.forename: Cees J
authors.initials: CJ
authors.lastname: de Vries
authors.forename: Dirk J A
authors.initials: DJ
authors.lastname: Lok
authors.forename: Diederick E
authors.initials: DE
authors.lastname: Grobbee
authors.forename: Barbara J M
authors.initials: BJ
authors.lastname: Mulder
mesh_terms: D000328:Adult; D017281:Cost of Illness; D004522:Educational Status; D005260:Female; D006330:Heart Defects, Congenital / Q000453:epidemiology*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007398:Interpersonal Relations; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D012042:Registries; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D013177:Sports; D019966:Substance-Related Disorders / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014478:Unemployment / Q000706:statistics & numerical data