Introduction: Cardiovascular diseases (CVDs) are shaped by multiple factors, including socio-economic status. Deprivation Indexes (DIs) are increasingly used to improve the stratification of CVD risk and targeting interventions. Hypothesis: This study assess whether contextual deprivation, measured by DI, is associated with CVD risk factors and estimated 10-year risk of CVDs. Methods: Two national health examination surveys (1998–2002 and 2008–2012) were conducted in Italy within the CUORE Project. Random samples of residents aged 35–74 years were examined (4,702 men, 4,597 women – and – 3,660 men, 3,699 women). The DI, as composed score of low level of education, unemployment, non-home ownership, one-parent family and overcrowding calculated in each municipality and census block using 2001 and 2011 Censuses of Population data, was assigned geolocating each participant residence. The 10-year risk of first fatal and non-fatal CVDs was estimated using the CUORE Project risk score. Statistics were standardized by the 2013 European age-sex distribution and reported by DI quintiles (Q1 and Q5). Results: In 1998–2002, CVD risk resulted slightly higher in the most deprived (Q5) (men: 8.5 in Q1 vs 8.8% in Q5; women: 3.0 vs 3.6%). A significant association was observed between DI quintiles and obesity (m: 14.7 vs 19.5%; w: 16.6 vs 29.4%), BMI mean (m: 26.5 vs 27.1 kg/m 2 ; w: 25.6 vs 27.6 kg/m 2 ), sedentary lifestyle during leisure time (m: 31 vs 40%; w: 38 vs 64%), smoking habits (m: 28 vs 41%; w: 23 vs 24%), diabetes (m: 11vs 13%; w: 6 vs 10%), and hypertension (m: 55 vs 52%; w: 41 vs 50%). In 2008–2012, CVD risk remained slightly higher in Q5 (m: 12.5 vs 13.1%; w: 4.8 vs 4.9%) and again a significant association was observed between DI quintiles and obesity (m: 22 vs 31%; w: 20 vs 33%), BMI mean (m: 27 vs 28kg/m 2 ; w: 26 vs 28kg/m 2 ), sedentary lifestyle (m: 29 vs 35%; w: 40 vs 49%), diabetes (m: 10 vs 15%; w: 6 vs 12%), and for women hypertension (m: 53% in both Q1 and Q5; w: 35 vs 43%). No significant association was found for mean of SBP, diastolic blood pressure, glycemia, triglycerides, total and HDL cholesterol, and hypercholesterolemia prevalence in both periods, and smoking habits prevalence for the latter period. Conclusions: The study confirms also in Italy the association between deprivation and CVD risk factors, with DI emerging as a robust index of social and material disadvantage, supporting targeted health promotion strategies in deprived urban areas.
BOTTOSSO et al. (Tue,) studied this question.