- 作者：C¨ªlia Mej¨ªa-Lancheros ; Ram¨®n Estruch ; Miguel A. Mart¨ªnez-Gonz¨¢lez ; Jordi Salas-Salvad¨® ; Dolores Corella ; Enrique G¨®mez-Gracia ; Miquel Fiol ; Jos¨¦ Lapetra ; Maria I. Covas ; Fern ; o Ar¨®s ; Llu¨ªs Serra-Majem ; Xavier Pint¨® ; Josep Basora ; Jos¨¦ V. Sorl¨ª ; Miguel A. Mu?oz ; en nombre de los investigadores del estudio PREDIMED
- 关键词：ECV ; enfermedad cardiovascular ; NSE ; nivel socioeconó ; mico
- 刊名：Revista Espa?ola de Cardiologa
- 出版年：2013
- 出版时间：October, 2013
- 年：2013
- 卷：66
- 期：10
- 页码：803-811
- 全文大小：248 K
Introduction and objectives
Although it is known that social factors may introduce inequalities in cardiovascular health, data on the role of socioeconomic differences in the prescription of preventive treatment are scarce. We aimed to assess the relationship between the socioeconomic status of an elderly population at high cardiovascular risk and inequalities in receiving primary cardiovascular treatment, within the context of a universal health care system.
Methods
Cross-sectional study of 7447 individuals with high cardiovascular risk (57.5 % women, mean age 67 years) who participated in the PREDIMED study, a clinical trial of nutritional interventions for cardiovascular prevention. Educational attainment was used as the indicator of socioeconomic status to evaluate differences in pharmacological treatment received for hypertension, diabetes, and dyslipidemia.
Results
Participants with the lowest socioeconomic status were more frequently women, older, overweight, sedentary, and less adherent to the Mediterranean dietary pattern. They were, however, less likely to smoke and drink alcohol. This socioeconomic subgroup had a higher proportion of coexisting cardiovascular risk factors. Multivariate analysis of the whole population found no differences between participants with middle and low levels of education in the drug treatment prescribed for 3 major cardiovascular risk factors (odds ratio [95 % confidence interval]): hypertension (0.75 [0.56-1.00] vs 0.85 [0.65-1.10]); diabetic participants (0.86 [0.61-1.22] vs 0.90 [0.67-1.22]); and dyslipidemia (0.93 [0.75-1.15] vs 0.99 [0.82-1.19], respectively).
Conclusions
In our analysis, socioeconomic differences did not affect the treatment prescribed for primary cardiovascular prevention in elderly patients in Spain. Free, universal health care based on a primary care model can be effective in reducing health inequalities related to socioeconomic status.
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