title: Frequency of cardiovascular diseases and risk factors treated in France according to social deprivation and residence in an overseas territory.
abstract: BACKGROUND
  The frequencies of treated cardiovascular disease (CVD) and their associated risk factors (CVRF) may vary according to socioeconomic and territorial characteristics.
  
  
  METHODS
  These frequencies have been described for 48million policyholders of the French general health insurance scheme, according to a metropolitan geographical deprivation index in five quintiles (from the least to the most deprived: Q1 to Q5), the existence of universal complementary health cover (CMUC) in individuals under the age of 60, and residence in a French overseas territory (FOT). The information system (SNIIRAM) was used to identify CVDs and anti-diabetic, anti-hypertensive or lipid-lowering treatments by three reimbursements in 2010.
  
  
  RESULTS
  After age- and sex-specific adjustment, the inhabitants of the most deprived areas more often suffered from distal arterial disease (Q5/Q1=1.5), coronary artery disease (1.2) and cerebral vascular accident (1.1), as did the CMUC beneficiaries compared to non-beneficiaries (ratios of 1.7, 1.3 and 1.5), and the FOT residents in comparison to the most deprived metropolitan quintile (Q1), with the exception of coronary artery disease (1.2, 0.6 and 1.2). Inhabitants of the most deprived areas more often received anti-diabetic and anti-hypertensive treatment (Q5/Q1=1.4 and 1.2), as did the people on the CMUC (2.0 and 1.2) and the FOT inhabitants (FOT/Q1=2.4 and 1.3). These ratios were of 1.1, 1.0 and 0.8 for lipid-lowering drugs.
  
  
  CONCLUSIONS
  These results pinpoint populations for which specific preventative initiatives could be supported. While health care service utilisation is facilitated (CMUC), it is probably not yet effective enough in view of the persistent increased cardiovascular risk.
authors.affiliation: General Health Insurance Scheme (Caisse Nationale d'Assurance Maladie des Travailleurs Salariés), Paris, France. Electronic address: philippe.tuppin@cnamts.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Tuppin
authors.affiliation: General Health Insurance Scheme (Caisse Nationale d'Assurance Maladie des Travailleurs Salariés), Paris, France.
authors.forename: Pauline
authors.initials: P
authors.lastname: Ricci-Renaud
authors.affiliation: French Institute for Public Health Surveillance, Saint Maurice, France.
authors.forename: Christine
authors.initials: C
authors.lastname: de Peretti
authors.affiliation: General Health Insurance Scheme (Caisse Nationale d'Assurance Maladie des Travailleurs Salariés), Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Fagot-Campagna
authors.affiliation: General Health Insurance Scheme (Caisse Nationale d'Assurance Maladie des Travailleurs Salariés), Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Alla
authors.affiliation: Department of Cardiology, Hôpital Européen Georges Pompidou, Université Paris Descartes, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Danchin
authors.affiliation: General Health Insurance Scheme (Caisse Nationale d'Assurance Maladie des Travailleurs Salariés), Paris, France.
authors.forename: Hubert
authors.initials: H
authors.lastname: Allemand
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000191:economics* / Q000208:ethnology* / Q000628:therapy; D003906:Developing Countries / Q000191:economics*; D005260:Female; D005602:France / Q000208:ethnology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D011203:Poverty / Q000191:economics / Q000208:ethnology; D012111:Residence Characteristics; D012307:Risk Factors; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Arterial hypertension; Blood lipids; Cardiovascular disease; Diabetes; Epidemiology; Social deprivation