title: Association of socioeconomic status measured by education, and cardiovascular health: a population-based cross-sectional study.
abstract: OBJECTIVE
  Cardiovascular health (CVH) is a relatively new concept defined by the American Heart Association (AHA). The aim of the present study was to assess whether the indices of CVH were discriminators of socioeconomic status (SES) in the adult population of the Republic of Srpska (RS).
  
  
  METHODS
  Population-based cross-sectional study.
  
  
  METHODS
  RS, Bosnia and Herzegovina.
  
  
  METHODS
  The study involved 4165 adults aged ≥18 years (mean age 50.2; 54% women) who participated in the National Health Survey performed from September to November 2010 in the RS.
  
  
  METHODS
  Participant's education was a proxy for SES. Potential discriminators of SES were indices of CVH presented according to AHA as: ideal health behaviours index (non-smoking, body mass index <25 kg/m(2), physical activity at goal level and healthy diet); ideal health factors index (untreated total cholesterol <200 mg/dL, untreated blood pressure <120/<80 mm Hg, untreated fasting glucose <100 mg/dL and non-smoking); and ideal CVH status (defined as all seven ideal health metrics present) versus intermediate and poor CVH status.
  
  
  RESULTS
  Participants with high educational levels had a significantly greater number of ideal CVH metrics, and ideal health factor metrics compared with those with low or medium educational level (OR 0.88 95% CI 0.77 to 0.99 and OR 0.88 95% CI 0.80 to 0.96; OR 0.81 95% CI 0.69 to 0.96 and OR 0.77 95% CI 0.68 to 0.87; respectively). The number of ideal behaviour metrics was not a discriminator of educational groups. Concerning the categories of CVH status the poor CVH was a discriminator for low and medium education compared with those with high education (OR 1.93 95% CI 1.24 to 3.01 and OR 1.54 95% CI 1.08 to 2.19, respectively).
  
  
  CONCLUSIONS
  Our findings emphasise the large potential for preventing cardiovascular disease, showing a low proportion with a favourable CVH profile, especially among low-educated people. It is necessary to consider prevention strategies aimed at improving CVH in RS, targeting primarily low educational groups.
authors.affiliation: Faculty of Medicine, Institute of Epidemiology, University of Belgrade, Belgrade, Serbia.
authors.forename: Slavenka
authors.initials: S
authors.lastname: Janković
authors.affiliation: Institute of Public Health Republic of Srpska, Banja Luka, Bosnia and Herzegovina.
authors.forename: Dragana
authors.initials: D
authors.lastname: Stojisavljević
authors.affiliation: Faculty of Medicine, Institute of Social Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Janko
authors.initials: J
authors.lastname: Janković
authors.affiliation: Faculty of Economics, Finance and Administration, Singidunum University, Belgrade, Serbia.
authors.forename: Miloš
authors.initials: M
authors.lastname: Erić
authors.affiliation: Faculty of Medicine, Institute of Medical Statistics and Informatics, University of Belgrade, Belgrade, Serbia.
authors.forename: Jelena
authors.initials: J
authors.lastname: Marinković
mesh_terms: D000293:Adolescent; D000328:Adult; D017522:Bosnia and Herzegovina; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D012923:Social Class; D055815:Young Adult
keywords: EPIDEMIOLOGY; PREVENTIVE MEDICINE; PUBLIC HEALTH