Socioeconomic differences in the prevalence, treatment and control of major cardiometabolic risk factors by sex: a cross-sectional study of the UK Biobank

Introduction Social deprivation is related to cardiovascular risk, but the prevalence of cardiometabolic risk factors by deprivation and sex is less explored. We addressed this in a large UK cohort. Methods 500 769 UK Biobank participants (54.4% women) with ≥1 baseline risk factor measured were included. We examined differences in risk factors, including treatment and control, by socioeconomic status (Townsend score fifths) and sex. Results Total cholesterol, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol were lower with greater deprivation and systolic blood pressure was lower, while C-reactive protein was higher. Body mass index, waist circumference and triglycerides were also higher with greater deprivation, with larger differences in women than men. Corresponding social differences in glycated haemoglobin and glucose were higher in men than in women while estimated glomerular filtration rate was higher in men only. The prevalence of hypertension and chronic kidney disease was higher with greater deprivation (% difference between least and most deprived (95% CI 5.1 (4.7 to 5.6) and 0.9 (0.8 to 1.1), respectively), but varied by sex for smoking (12.1 (11.6 to 12.5) vs 15.4 (14.9 to 15.9) in women vs men, respectively), obesity (13.7 (13.1 to 14.2) vs 8.2 (7.7 to 8.8)) and diabetes (2.6 (2.3 to 2.8) vs 3.8 (3.4 to 4.1)). Treatment and control of hypertension and dyslipidaemia were higher with greater deprivation. Conclusions Apart from total cholesterol and LDL-C, greater social deprivation relates to worse cardiometabolic risk factors. Social differences vary by sex for several risk factors, including higher smoking among men and obesity among women. Public health interventions considering both deprivation and sex are warranted.