title: Association between cardiovascular disease and socioeconomic level in Portugal.
abstract: BACKGROUND
  Cardiovascular disease is the leading cause of morbidity, mortality and disability in Portugal. Socioeconomic level is known to influence health status but there is scant evidence on socioeconomic inequalities in cardiovascular disease in Portugal.
  
  
  OBJECTIVE
  To analyze the distribution of cardiovascular disease in the Portuguese population according to socioeconomic status.
  
  
  METHODS
  We conducted a cross-sectional study using data from the fourth National Health Survey on a representative sample of the Portuguese population. Socioeconomic inequalities in cardiovascular disease, risk factors and number of medical visits were analyzed using odds ratios according to socioeconomic status (household equivalent income) in the adult population (35-74 years). Comparisons focused on the top and bottom 50% and 10% of household income distribution.
  
  
  RESULTS
  Of the 21 807 individuals included, 53.3% were female, and mean age was 54 ± 11 years. Cardiovascular disease, stroke, ischemic heart disease, hypertension, diabetes, obesity and physical inactivity were associated with lower socioeconomic status, while smoking was associated with higher status; number of medical visits and psychological distress showed no association. When present, inequality was greater at the extremes of income distribution.
  
  
  CONCLUSIONS
  The results reveal an association between morbidity, lifestyle and socioeconomic status. They also suggest that besides improved access to effective medical intervention, there is a need for a comprehensive strategy for health promotion and disease prevention that takes account of individual, cultural and socioeconomic characteristics.
authors.affiliation: Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal; Hospital de Santa Maria, Centro Académico de Medicina de Lisboa, Serviço de Cardiologia I, CCUL, Lisboa, Portugal. Electronic address: soniaduarteribeiro@gmail.com.
authors.forename: Sónia
authors.initials: S
authors.lastname: Ribeiro
authors.forename: Cláudia
authors.initials: C
authors.lastname: Furtado
authors.forename: João
authors.initials: J
authors.lastname: Pereira
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011174:Portugal / Q000453:epidemiology; D012959:Socioeconomic Factors
keywords: AVC; Acidente vascular cerebral; CID; Cardiovascular disease; Classificação internacional de doenças; DCI; DCV; DM; Desigualdades; Diabetes mellitus; Doença cardiovascular; Doença cardíaca isquémica; Doenças cardiovasculares; FRCV; Fator de risco cardiovascular; Fatores socioeconómicos; HTA; Hipertensão arterial; IMC; Inequalities; MHI; Mental Health Inventory; NSE; Nível socioeconómico; OCDE; OMS; OR; Odds Ratio; Odds ratio; Organização Mundial de Saúde; Organização para a Cooperação e Desenvolvimento Económico; PNS; Plano Nacional de Saúde; REEM-OCDE; Rendimento equivalente de acordo com a escala modificada da OCDE; Socioeconomic factors; Índice de massa corporal