What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Cardiovascular risk factors (n=2833). Intervention: No university education vs. University education. Primary outcome: Risk of obesity in females (OR 2.5, 95% CI 1.5 to 4.2).

September 29, 2014Open Access

Cardiovascular risk factors, lifestyle, and social determinants: a cross-sectional population study

Key Result

Females without a university education had a 2.5-fold higher risk of obesity, smoking, and sedentary behavior compared to those with a university education.

Study Design

Type

Cross-Sectional (n=2,833)

Multicenter

Yes

PICO

Population

Cardiovascular risk factors (n=2,833)

Intervention / Comparator

No university education vs University education

Primary Outcome

Risk of obesity in females — OR 2.5 (1.5 to 4.2)

Main Result

Effect estimate: OR 2.5 (95% CI 1.5 to 4.2)

Limitations

Not all potentially important confounders with regard to socioeconomic status were fully assessed (e.g., marital status, housing type, rurality).
Other recognized cardiovascular risk factors, such as chronic renal disease, were not considered.
Absence of social class as an integrating variable of socioeconomic status and educational level.
Cross-sectional design precludes establishing a causal relationship between risk factors and social determinants.

Abstract

BACKGROUND: The influence of socioeconomic development is often disregarded in epidemiological studies into the prevalence of cardiovascular risk factors. AIM: To analyse the relationship between major cardiovascular risk factors and socioeconomic indicators. DESIGN AND SETTING: Cross-sectional, population-wide study in primary care practices in the health area of Don Benito-Villanueva de la Serena, Badajoz, Extremadura, Spain. METHOD: A total of 2833 people aged 25-79 years (mean age 51.2 years), representative of the population, participated in the study. The prevalence and odds ratios (ORs) were calculated for diabetes, arterial hypertension, obesity, hypercholesterolaemia, smoking, and sedentary behaviour, according to level of education and employment status. RESULTS: A high prevalence of cardiovascular risk factors related to the level of education and employment status. Females who had not studied at university had a higher risk of obesity (OR = 2.5, 95% confidence interval CI = 1.5 to 4.2), smoking (OR 2.5, 95% CI = 1.7 to 3.7), and sedentary behaviour (OR = 2.5, 95% CI = 1.5 to 3.9) than females with a university education. Males who had not studied at university showed an increased risk of smoking (OR = 2.1, 95% CI = 1.4 to 3.1), arterial hypertension (OR = 1.5, 95% CI = 1.0 to 2.4), hypercholesterolaemia (OR = 1.5, 95% CI = 1.0 to 2.2), and obesity (OR = 1.5, 95% CI = 1.0 to 2.3) than males with a university education. The risk of obesity was higher in unemployed females than those in paid employment (OR =1.4, 95% CI = 1.1 to 1.9), but they showed a lower risk of smoking (OR = 0.7, 95% CI = 0.5 to 0.9). CONCLUSION: The study results confirm an inverse association between the level of education and the prevalence of cardiovascular risk factors. Public health studies and interventions are needed to understand this association and develop interventions targeted at the population that is at greatest risk.

Mark Helpful

Bookmark

Relay

View Full Paper