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Sex differences in cardiovascular disease in relation to socioeconomic position in the NAKO study

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Title: Sex differences in cardiovascular disease in relation to socioeconomic position in the NAKO study
Authors: Moreno Velasquez, I, Peters, SAE, Dragano, N, Greiser, K, Dörr, M, Fischer, B, Berger, K, Hannemann, A, Peters, A, Pischon, T
Source: European Journal of Public Health ; volume 34, issue Supplement_3 ; ISSN 1101-1262 1464-360X
Publisher Information: Oxford University Press (OUP)
Publication Year: 2024
Description: Background Low socioeconomic position (SEP) is associated with cardiovascular disease (CVD) risk; yet, the underlying pathways are not fully clear and may affect sexes differently. We investigated sex differences in the relationship of SEP with prevalent CVD, cardiovascular risk factors (CRF) and estimated cardiovascular risk in a contemporaneous German population. Methods Data derived from the baseline examination of 204,780 participants in population-based German National Cohort (NAKO). Logistic, multinomial, and linear regression models were used to estimate sex-specific odds ratios (OR) and beta-coefficients with 95% confidence intervals (CI) of CVD, CRF and very high-risk score (SCORE2 ≥7.5% (age 40-49 years) or ≥ 10% (age 50-69 years)) associated with educational attainment and relative income. Women-to-men ratios of ORs (RORs) with 95%-CI were estimated. Results In women compared to men, low vs. high SEP was more strongly associated with obesity, overweight, self-reported myocardial infarction and hypertension, elevated blood pressure values, antihypertensive medication, and alcohol consumption, but less strongly related to smoking. In women with the lowest vs. highest educational level, the OR for a very high 10-year CVD risk was 3.61 (95%-CI 2.88; 4.53), compared to 1.72 (95%-CI 1.51; 1.96) in men. The women-to-men-ROR was 2.33 (95%-CI 1.78; 3.05), attenuated after age-adjustments. For the comparison of low vs. high relative income, the odds of having a very high 10-year CVD risk was 2.55 (95%-CI 2.04; 3.18) in women, and 2.25 (95%-CI 2.08; 2.42) in men (women-to-men ROR, 1.31 (95%-CI 1.05; 1.63). Conclusions In both sexes, there was an inverse graded relationship between SEP and the likelihood of prevalent CVD and CRF, with stronger associations in women than in men. Although women had a lower estimated 10-year CVD risk compared to men, the likelihood of having a very high CVD risk conferred by low SEP vs. a high one was higher in women than in men.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/eurpub/ckae144.496
Availability: https://doi.org/10.1093/eurpub/ckae144.496
https://academic.oup.com/eurpub/article-pdf/34/Supplement_3/ckae144.496/60118683/ckae144.496.pdf
Rights: https://creativecommons.org/licenses/by-nc/4.0/
Accession Number: edsbas.1410ABFA
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  Data: Sex differences in cardiovascular disease in relation to socioeconomic position in the NAKO study
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  Data: <searchLink fieldCode="AR" term="%22Moreno+Velasquez%2C+I%22">Moreno Velasquez, I</searchLink><br /><searchLink fieldCode="AR" term="%22Peters%2C+SAE%22">Peters, SAE</searchLink><br /><searchLink fieldCode="AR" term="%22Dragano%2C+N%22">Dragano, N</searchLink><br /><searchLink fieldCode="AR" term="%22Greiser%2C+K%22">Greiser, K</searchLink><br /><searchLink fieldCode="AR" term="%22Dörr%2C+M%22">Dörr, M</searchLink><br /><searchLink fieldCode="AR" term="%22Fischer%2C+B%22">Fischer, B</searchLink><br /><searchLink fieldCode="AR" term="%22Berger%2C+K%22">Berger, K</searchLink><br /><searchLink fieldCode="AR" term="%22Hannemann%2C+A%22">Hannemann, A</searchLink><br /><searchLink fieldCode="AR" term="%22Peters%2C+A%22">Peters, A</searchLink><br /><searchLink fieldCode="AR" term="%22Pischon%2C+T%22">Pischon, T</searchLink>
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  Data: European Journal of Public Health ; volume 34, issue Supplement_3 ; ISSN 1101-1262 1464-360X
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  Data: Oxford University Press (OUP)
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  Label: Publication Year
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  Data: 2024
– Name: Abstract
  Label: Description
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  Data: Background Low socioeconomic position (SEP) is associated with cardiovascular disease (CVD) risk; yet, the underlying pathways are not fully clear and may affect sexes differently. We investigated sex differences in the relationship of SEP with prevalent CVD, cardiovascular risk factors (CRF) and estimated cardiovascular risk in a contemporaneous German population. Methods Data derived from the baseline examination of 204,780 participants in population-based German National Cohort (NAKO). Logistic, multinomial, and linear regression models were used to estimate sex-specific odds ratios (OR) and beta-coefficients with 95% confidence intervals (CI) of CVD, CRF and very high-risk score (SCORE2 ≥7.5% (age 40-49 years) or ≥ 10% (age 50-69 years)) associated with educational attainment and relative income. Women-to-men ratios of ORs (RORs) with 95%-CI were estimated. Results In women compared to men, low vs. high SEP was more strongly associated with obesity, overweight, self-reported myocardial infarction and hypertension, elevated blood pressure values, antihypertensive medication, and alcohol consumption, but less strongly related to smoking. In women with the lowest vs. highest educational level, the OR for a very high 10-year CVD risk was 3.61 (95%-CI 2.88; 4.53), compared to 1.72 (95%-CI 1.51; 1.96) in men. The women-to-men-ROR was 2.33 (95%-CI 1.78; 3.05), attenuated after age-adjustments. For the comparison of low vs. high relative income, the odds of having a very high 10-year CVD risk was 2.55 (95%-CI 2.04; 3.18) in women, and 2.25 (95%-CI 2.08; 2.42) in men (women-to-men ROR, 1.31 (95%-CI 1.05; 1.63). Conclusions In both sexes, there was an inverse graded relationship between SEP and the likelihood of prevalent CVD and CRF, with stronger associations in women than in men. Although women had a lower estimated 10-year CVD risk compared to men, the likelihood of having a very high CVD risk conferred by low SEP vs. a high one was higher in women than in men.
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  Data: 10.1093/eurpub/ckae144.496
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  Data: https://doi.org/10.1093/eurpub/ckae144.496<br />https://academic.oup.com/eurpub/article-pdf/34/Supplement_3/ckae144.496/60118683/ckae144.496.pdf
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