居民社会经济状况与心血管病危险因素的关系

目的 探讨居民社会经济状况(Socioeconomic Status，SES)和心血管病危险因素之间的关系，为干预的重点人群的确定提供科学依据。方法 利用1997年及1998年广东省糖尿病流行病学调查资料分析社会经济状况和心血管病危险因素之间的关系。结果 男性的社会经济状况指标优于女性。调整年龄、职业性体力活动、休闲体力活动和饮酒后，SES对心血管病危险因素仍有影响，其中受教育程度和居住地区的影响较大，其关联在男女不同。结论 社会经济状况是心血管病危险因素的重要影响因子，对社会经济状况好的女性施加干预可能会取得更好的效果。     

Associations between overall physical activity level and cardiovascular risk factors in an adult population

Background It is well established that physical activity level is inversely associated with cardiovascular morbidity and mortality, and with all-cause mortality. However, the dose–response relationship between physical activity and other cardiovascular disease risk factors is not fully understood. The aim of the present study was to explore the dose–response relationship between daily physical activity, as measured by a metabolic equivalent score, and BMI, waist circumference, waist hip ratio, total cholesterol, HDL, LDL, triglycerides, systolic and diastolic blood pressure. Methods A total of 1693 men and women, 33–64 years of age, from the 3 year follow-up of a population-based intervention study, were included in this cross-sectional study. Information on physical activity and other lifestyle factors was obtained by self-report questionnaire. Associations between activity level and biological variables were explored by general linear regression. Results Data from 835 (51%) men and 805 (49%) women were included. Mean age was 50.8 years (33–64). A significant inverse association between average 24-hour physical activity level ≤45 METs and waist circumference (men p = 0.012, women p = 0.011), BMI (p = 0.0004), waist-hip-ratio (p = 0.002) and triglycerides (p = 0.0001) was found as well as a positive association with HDL (p = <0.0001). In those with an activity level above 45 METs there were no associations. No association was found with total cholesterol, LDL, systolic or diastolic blood pressure. Conclusion This study suggests a linear dose–response relationship between activity level and certain biological cardiovascular risk factors up to a threshold of a daily 24 h MET-score of 45, which corresponds to a moderate physical activity level. Electronic Supplementary Material The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Relationship of socioeconomic status with cardiovascular risk factors and lifestyle in a Mediterranean population

BACKGROUND: Socioeconomic status greatly affects cardiovascular risk factors and lifestyle. Aim of the study To analyse the relationship between socioeconomic status and both cardiovascular risk factors and behavioural variables. AIM OF THE STUDY: To analyse the relationship between socioeconomic status and both cardiovascular risk factors and behavioural variables. METHODS: The present random sample of 838 men and 910 women of the 25 to 74 year old general population of Gerona according to the 1991 census, included cardiovascular risk factor measurements (total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, glycaemia, systolic blood pressure, diastolic blood pressure, body mass index, waist to hip ratio, and waist circumferences) and evaluation of dietary habits, alcohol consumption, smoking, and leisure-time physical activity with corresponding questionnaires. RESULTS: In this study, we used lifestyle factors (leisure-time physical activity, tobacco consumption, and alcohol drinking habits) in addition to dietary habits to determine whether changes in these factors correlate with the socioeconomic status, classified as degree of educational level, in a representative Spanish Mediterranean population. Multiple linear regression analysis adjusted for several confounders revealed a direct association of LDL-cholesterol (p = 0.03) and body mass index (p = 0.02) with low levels of educational status in men and women, respectively. A higher educational status was directly (p = 0.04) related to the smoking status in women. The two composite dietary scores, indicating overall dietary quality and cardiovascular protecting properties, were not associated with low socioeconomic status in our population. CONCLUSION: Dietary habits, alcohol drinking, and leisure-time physical activity seems not to be affected by educational status in either gender. This finding might partially explain the relationship between cardiovascular risk factors and socioeconomic status in our population. The importance of cultural values in the rural area of the Spanish province seems to be the stronger factor compared with education.     

Race disparities in cardiovascular disease risk factors within socioeconomic status strata

Purpose

Racial differences in socioeconomic status (SES) explain some, but not all, of racial disparities in cardiovascular disease (CVD) risk. To address this, race disparities among higher SES individuals need to be assessed. The purpose of this study was to assess whether racial disparities in CVD risk factors differ by SES levels.

Changes in cardiovascular risk factors in different socioeconomic groups: seven year trends in a Chinese urban population

STUDY OBJECTIVE: To analyse trends in socioeconomic differences in cardiovascular disease risk factors among an urban Chinese population using educational attainment as the socioeconomic indicator. DESIGN: Population surveys with randomly selected independent samples were carried out in 1989 and in 1996. Educational attainment, blood pressure, body mass index, cigarette smoking and lack of leisure time physical activity were determined. SETTING: Urban areas of the city of Tianjin, China. PARTICIPANTS: A total of 14 275 respondents aged 25-64 years. MAIN RESULTS: Diastolic blood pressure increased and the proportion of people without leisure time physical activity decreased in both sexes during the study period. The prevalence of smoking and the number of cigarettes smoked daily increased significantly among men. Smoking decreased in the least educated men and increased in those who had studied at least to college level. Body mass index decreased across all educational strata in women, but blood pressure increased in women with at least college level education. CONCLUSIONS: These data reveal a different picture in trends in the association of education and cardiovascular risk factors from those depicted in developed countries. This highlights the need for an effective intervention programme in the study population.     

Relationship of physical activity to cardiovascular risk factors in an urban population of Nigerian adults

Background

The burden of chronic diseases including cardiovascular disease (CVD) is increasing rapidly in Nigeria, but fewer studies have evaluated the role of physical activity in the development of CVD in this country. We examined the relationship between health enhancing physical activity and risk factors of CVD in a working population of adults in Maiduguri, Nigeria.

Methods

In a cross-sectional study, we assessed health enhancing moderate-to-vigorous physical activity (MVPA) among 292 government employees (age: 20–65 years, 40% female, 24% obese and 79.8% response) using the self-administered version of International Physical Activity Questionnaire (IPAQ-SF). Time spent in walking and sitting during occupational activity was assessed as well. Anthropometric measurement of height, weight and waist circumference, and blood pressure were also measured. Independent t-test and One- Way ANOVA were conducted, and the relationships between MVPA and body mass index (BMI), waist circumference, blood pressure and heart rate were explored using Pearson correlations coefficients and multiple regression analyses.

Results

The mean time spent in health enhancing MVPA (116.4 ± 101.3 min/wk) was lower than the recommended guideline of 150 min/wk sufficient for health benefits. Compared with men, more women were less physically active, obese and reported more diagnoses of component of metabolic syndrome (p < 0.05). Participants whose work activities were highly sedentary tend to accumulate less minutes of MVPA compared with those who reported their work as moderately active or highly active (p < 0.001). Health enhancing MVPA was inversely related with body mass index (BMI), waist circumference, heart rate, and systolic and diastolic blood pressure (p < 0.05).

Conclusion

Physical activity level of the working population of Nigerian adults was low and was related with adverse risk factors for CVD. Promoting health enhancing physical activity at work places may be important for prevention and control of CVD among the working population in Maiduguri, Nigeria.     

Associations between glycated hemoglobin levels and atherosclerotic risk factors in urban communities

PURPOSE: To prevent coronary heart disease and type 2 diabetes mellitus, we need to focus on "the deadly quartet" (coexistence of upper-body obesity, glucose intolerance, hypertriglyceridemia, and hypertension), and the multiple risk factor syndrome related to insulin resistance. As few urban community-based population studies have evaluated the correlation between glycated hemoglobin A1c (HbA1c) levels and risks of life-style related disease, we investigated this parameter and its correlation with atherosclerotic risk factors in participants of health check ups in two communities in Kanagawa prefecture. We also examined whether these correlations were affected by difference between the two groups. METHODS: The study populations comprised male and female residents aged 40-79 in two communities (A and B cities) in 1998. Age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), HDL-cholesterol (HDL-C), triglycerides (TG), GOT, GPT, Uric acid (UA), and gamma GTP were considered as atherosclerotic risk factors. Firstly we calculated correlation coefficients with HbA1c level. Secondly, logistic regression analyses were performed with HbA1c as the dependent variable, and risk factors correlated with HbA1c significantly and variable for each community as independent variables. To assess whether community differences affect associations between HbA1c levels and risk factors, we added interaction terms as independent variables in the logistic regression analysis. RESULTS: 1. There were no significant interaction terms while significant positive associations were observed between HbA1c and age, BMI, and levels of TC and gamma GTP for men in both communities. A significant negative association was observed between HbA1c and UA.. 2. Age, BMI, and the levels of SBP, TG, GPT, and gamma GTP were positively associated, and GOT was negatively associated with the HbA1c levels in women in both communities. Each community had its own association between TC and HbA1c. CONCLUSIONS: The findings that TC is associated with HbA1c in men, and that BMI and the level of TC are linked with HbA1c in women are consistent with previous results for Japanese. The association between HbA1c and TG in women was newly observed for Japanese. Furthermore, the levels of gamma GTP in both sexes and also GPT in women are associated with HbA1c. From these results, investigating linkage between HbA1c level and atherosclerotic risk factors was thought to be appropriate for estimating accumulation of multiple risk factors in the community.     

Association between socioeconomic status and adiposity in urban Cameroon

BACKGROUND: As the relation between socioeconomic status (SES) and obesity may depend on the stage of development of a country, this relation is assessed in adults from urban Cameroon. METHODS: A sample comprising 1530 women and 1301 men aged 25 years and above, from 1897 households in the Biyem-Assi health area in the capital of Cameroon, Yaoundé, were interviewed about their household amenities, occupation, and education. Weight, height, and waist circumference were measured and subjects were classified as obese if their BMI>or=30 kg/m2 or overweight if BMI was between 25.0 and 29.9 kg/m2. Abdominal obesity was defined by a waist circumference>or=80 cm in women and>or=94 cm in men. RESULTS: Of the sample studied 33% of women and 30% of men were overweight (P<0.08), whereas 22% of women and 7% of men were obese (P<0.001). Abdominal obesity was present in 67% of women and 18% of men (P<0.001). After adjusting for age, leisure time physical activity, alcohol consumption, and tobacco smoking, the prevalence of overweight+obesity, obesity, and abdominal obesity increased with quartiles of household amenities in both genders and with occupational level in men. CONCLUSION: SES is positively associated with adiposity in urban Cameroon after adjusting for confounding factors.     

Coronary risk factors and socioeconomic status in Eastern Finland

Known CHD risk factors are strongly related to behavior and are rooted in cultural and social patterns. For any preventive community program, it is essential to clarify the connection between these risk factors and the socioeconomic situation of the given population. Before launching a comprehensive cardiovascular community program in North Karelia, a county in Eastern Finland with the world's highest known incidence rates of CHD, a large baseline survey was carried out on a representative sample of the population with a participation rate of 90%. Lower socioeconomic status (rural living, lower educational level and income, heavy physical work) was generally associated with CHD risk factors, i.e., smoking, high serum cholesterol, and high blood pressure, although with regard to blood pressure, the association was weak for men. The main departure was observed among women, where smoking in general was rare and was mainly associated with higher socioeconomic status. The findings are in agreement with current knowledge about the occurrence of the disease in the same population. The findings in Eastern Finland are discussed in the light of previous studies and possible social change during the last year.     

Associations between anxious-depressed symptoms and cardiovascular risk factors in a longitudinal childhood study

Objective

To examine the influence of anxious/depressed scores on cardiovascular risk factors throughout childhood.

Methods

Data from the Western Australian Pregnancy Cohort (Raine) Study, a study of 2900 pregnancies recruited between 1989 and 1991, were used. Anxious-depressed scores (derived from the Childhood Behavior Checklist), body mass index (BMI) and blood pressure were measured at 5 (n = 1681), 8 (n = 1697), 10 (n = 1575) and 14 (n = 1386) years. At age 14 depressive symptom scores (Beck Depression Inventory for Youth), anxious-depressed scores (Youth Self-Report (YSR) and Teacher Report Form (TRF)) and fasting lipid, glucose and insulin were also available. Cross sectional and longitudinal analyses were conducted.

Results

At age 14, girls with higher anxious-depressed scores had higher BMI (p ≤ 0.005) and homeostasis model assessment-estimated insulin resistance (p ≤ 0.0001). This equated to a difference of 0.6 kg/m² and 0.3 units in predicted BMI and HOMA-IR respectively (top 5% vs. score of zero). Boys with higher anxious-depressed scores had lower systolic blood pressure trajectories (p = 0.024).

Conclusion

Depressive scores appear to have differing influences on BMI, homeostasis model assessment-estimated insulin resistance and systolic blood pressure in boys and girls. Paradoxically boys with higher anxious-depressed scores had lower blood pressure throughout childhood.     

Plasma carotenoids are associated with socioeconomic status in an urban Indigenous population: an observational study

Background  

Indigenous Australians experience poorer health than other Australians. Poor diet may contribute to this, and be related to their generally lower socioeconomic status (SES). Even within Indigenous populations, SES may be important. Our aim was to identify factors associated with plasma carotenoids as a marker of fruit and vegetable intake among urban dwelling Indigenous Australians, with a particular focus on SES.     

亚健康状态与心血管疾病危险因素关系

目的探讨亚健康状态与血清皮质醇以及血压、血糖和血脂等心血管疾病危险因素的关系。方法选取首都医科大学附属宣武医院体检中心的健康体检者,进行一般情况和亚健康状态问卷(SHSQ-25)调查,采集静脉血检测血清皮质醇、血糖和血脂相关指标并测量血压;共获得资料完整者812人,以亚健康状态问卷总分≥35分为亚健康组,<35分作为对照组,比较2组人群各检测指标差异,并采用结构方程模型分析亚健康状态与心血管疾病危险因素的关系。结果亚健康组收缩压、空腹血糖、总胆固醇、低密度脂蛋白以及血清皮质醇水平均高于对照组(P<0.05);结构方程模型分析结果表明,亚健康人群应激水平与心血管疾病危险因素存在相关性,拟合指数(GFI)=0.998 8,调整拟合指数(AGFI)=0.993 6,平均残差率的根(RMSR)=0.429 8(95%CI=0.388 3～0.472 8),模型中各通径系数均有统计学意义(P<0.05)。结论亚健康状态与应激及心血管疾病危险因素相关。     

Contextual socioeconomic determinants of cardiovascular risk factors in rural south-west China: a multilevel analysis

Background  

We examined independent influences of contextual variables on cardiovascular risk factors in Shilin county, Yunnan province, South-west China.     

Associations of acculturation and socioeconomic status with subclinical cardiovascular disease in the multi-ethnic study of atherosclerosis

Objectives. We assessed whether markers of acculturation (birthplace and number of US generations) and socioeconomic status (SES) are associated with markers of subclinical cardiovascular disease—carotid artery plaque, internal carotid intima-media thickness, and albuminuria—in 4 racial/ethnic groups.Methods. With data from the Multi-Ethnic Study of Atherosclerosis (n = 6716 participants aged 45–84 years) and race-specific binomial regression models, we computed prevalence ratios adjusted for demographics and traditional cardiovascular risk factors.Results. The adjusted US- to foreign-born prevalence ratio for carotid plaque was 1.20 (99% confidence interval [CI] = 0.97, 1.39) among Whites, 1.91 (99% CI = 0.94, 2.94) among Chinese, 1.62 (99% CI = 1.28, 2.06) among Blacks, and 1.23 (99% CI = 1.15, 1.31) among Hispanics. Greater carotid plaque prevalence was found among Whites, Blacks, and Hispanics with a greater number of generations with US residence (P < .001) and among Whites with less education and among Blacks with lower incomes. Similar associations were observed with intima-media thickness. There was also evidence of an inverse association between albuminuria and SES among Whites and Hispanics.Conclusions. Greater US acculturation and lower SES were associated with a higher prevalence of carotid plaque and greater intima-media thickness but not with albuminuria. Maintenance of healthful habits among recent immigrants should be encouraged.Beginning with the Ni-Hon-San study,^1,2 which was initiated in the 1960s, research has associated increased acculturation to Western lifestyles with more-adverse cardiovascular disease (CVD) risk factor profiles and with increased CVD morbidity and mortality. Specifically, greater Western acculturation has frequently been linked to increased body mass index (BMI; weight in kilograms divided by height in meters squared),^3–5 waist circumference and abdominal obesity,^6,7 hypertension,^7–9 type II diabetes,^10,11 and CVD morbidity and mortality.^1,12,13 However, little research has explored associations between acculturation and subclinical CVD.^14,15Abundant research also exists that links low socioeconomic status (SES) to increased levels of CVD risk factors, morbidity, and mortality.^14,16–18 In general, SES has been found to be inversely related to subclinical measures of CVD, including coronary artery calcification (CAC),^14,19–22 carotid artery plaque, and intima-media thickness^20,23–26 and albuminuria.²⁷ Relations with peripheral artery disease have been inconsistent.^28–30 The extent to which these associations vary by race/ethnicity has been examined infrequently. There is, however, some evidence that the relation between SES and disease may differ across racial/ethnic groups.^14,31,32 Specifically, in the Multi-Ethnic Study of Atherosclerosis (MESA) there was a higher prevalence of CAC among Whites with low education than among those with more education, whereas the reverse was true for Hispanics.¹⁴We investigated whether acculturation and SES were associated with other measures of subclinical disease, specifically with carotid plaque and albuminuria. The relation of acculturation and SES to CAC has been described in MESA.¹⁴ Although CAC, carotid plaque, and albuminuria are all subclinical measures of CVD and are related to adverse clinical outcomes, these measures represent different aspects of the disease process and have relatively weak intercorrelations.³³ Thus, they may be differentially related to our exposures of interest.The investigation of these patterns is important from a public health perspective and may yield clues regarding the etiology of atherosclerosis. On the basis of previous work,¹⁴ we hypothesized that increased Western acculturation, as assessed by place of birth, migration history, and duration of US residence, is associated with increased carotid plaque, intima-media thickness, and albuminuria. Additionally, we expected there to be an interaction between race/ethnicity and SES with respect to their associations with subclinical CVD. Specifically, we expected Whites and Blacks at lower SES to have more-adverse subclinical CVD profiles than those at higher SES, whereas for Hispanics and Chinese, we expected the reverse to be true.     

Occupation, education, and income as socioeconomic indicators in relation to cardiovascular risk factors in the urban African.

A yardstick is needed for measuring the medical consequences of socioeconomic change in developing countries. Education, income, and a newly developed occupation index were studied in urban African males in relation to six coronary artery disease risk factors. Occupation was the status indicator best known to a man''s family, correlated best with the risk factors, and was not age dependent.