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Risk factors for coronary heart disease in different socioeconomic groups of Lithuania and Sweden--the LiVicordia
M Kristenson1, Z Kucinskiene, B Bergdahl
1Department of Environment and Health, Faculty of Health Sciences, Linköping, Sweden. Margareta.Kristenson@lio.se
Insights
Middle-aged men in Lithuania face higher coronary heart disease (CHD) risks due to factors like oxidative and psychosocial stress. These same risk factors are prevalent in lower socioeconomic groups within both Lithuania and Sweden, explaining health disparities.
Area of Science:
- Cardiovascular epidemiology
- Socioeconomic determinants of health
Background:
- Middle-aged Lithuanian men exhibit a significantly higher risk of coronary heart disease (CHD) mortality compared to their Swedish counterparts.
- Within Sweden, CHD mortality rates are notably higher among blue-collar workers than white-collar workers, suggesting a socioeconomic gradient.
Purpose of the Study:
- To investigate whether the risk factors identified in Lithuanian men, when compared to Swedish men, are also present in low socioeconomic groups within urban populations.
- To explore the relationship between socioeconomic status and specific health risk factors for CHD in a cross-national context.
Main Methods:
- The LiVicordia study involved 150 50-year-old men from Linköping, Sweden, and Vilnius, Lithuania.
- A comparative analysis assessed traditional and novel CHD risk factors, examining their prevalence across high and low socioeconomic groups within each city and the total sample, controlling for city-specific variations.
Main Results:
- Vilnius men were characterized by shorter stature, lower serum antioxidant vitamin levels, increased psychosocial strain, and a blunted cortisol response to laboratory stress.
- These risk factors were also observed in men from lower social classes in both cities.
- Linear regression linked low social class to short stature, low serum beta-carotene, poor social integration, low self-esteem, high vital exhaustion, and an abnormal cortisol stress response.
Conclusions:
- A shared set of risk factors, primarily related to oxidative and psychosocial stress, characterizes men in Lithuania and those in lower socioeconomic strata within both countries.
- These common risk factors provide a potential explanation for observed health differences both between and within nations.
Aims:
Lithuanian middle-aged men have a fourfold higher risk for coronary heart disease (CHD) mortality compared with Swedish men. In Sweden, CHD mortality is twice as high in blue- compared with white-collar workers. Whether the same risk factors that characterized Lithuanian men, compared with Swedish men, could be found in low socioeconomic groups within the cities was investigated.
Methods:
The LiVicordia study compared both traditional and new possible risk factors for CHD among 150 50-year-old men in Linköping, Sweden and Vilnius, Lithuania. A comparison was made of the prevalence of these risk factors in high and low socioeconomic groups within the cities and, after controlling for the city, variations across socioeconomic groups in the total sample.
Results:
Small differences were found in traditional risk factors between cities. However, Vilnius men were shorter, had lower serum levels of antioxidant vitamins, more psychosocial strain, and lower cortisol response to a standardized laboratory stress test. These characteristics were also found among men in low social classes in both cities. In linear regression models, short stature, low serum beta-carotene, low social integration, coping and self-esteem, high vital exhaustion, high baseline and low cortisol response to stress were related to low social class.
Conclusions:
The same set of risk factors, mainly relating to oxidative and psychosocial stress, that characterized Vilnius men was also found in men in low social classes within the cities. The results suggest that a common set of risk factors may help to explain health differences both between and within countries.
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