Socioeconomic inequality in cardiovascular disease and related illnesses in Portugal

INTRODUCTION AND OBJECTIVES: Cardiovascular diseases (CVDs) and related illnesses remain a leading cause of morbidity in Portugal. Socioeconomic status (SES) is known to influence cardiovascular outcomes, but there is limited evidence of this relationship in the Portuguese context. The objective of this article is to analyse inequalities in the prevalence of CVD and related illnesses according to SES in Portugal, focusing on the association with income and education. METHODS: A cross-sectional study was conducted using data from the 2019 Portuguese National Health Survey. Socioeconomic inequalities in CVD and related illnesses were assessed using relative concentration curves and indices (RCI), among adults aged 35-79. Inequality measures of health outcomes were adjusted for age and sex. RESULTS: Lower income is significantly associated with a higher prevalence of myocardial infarction, hypertension, coronary disease or angina, stroke, diabetes, elevated blood cholesterol and kidney disease with RCI of -0.104, -0.094, -0.185, -0.114, -0.112, -0.069, -0.170, respectively. Individuals with a lower education level also show a significantly higher concentration of CVDs and related illnesses, with a RCI of -0.295 for myocardial infarction, -0.201 for hypertension, -0.305 for coronary disease, -0.325 for stroke, -0.268 for diabetes, -0.168 for elevated blood cholesterol, and -0.239 for kidney disease. In general, lower educational attainment showed a greater association with disease concentration disparities. CONCLUSION: Inequalities in CVD and related illnesses in Portugal underline the need for comprehensive health promotion, disease prevention and management strategies that consider individuals' SES. Further research is essential to develop targeted interventions aimed at reducing these health inequalities effectively and to understand the interaction between SES and health outcomes.