A Global Perspective on Cardiovascular Risk Factors by Educational Level in CHD Patients: SURF CHD II

Area of Science:

• Cardiology
• Public Health
• Health Services Research

Background:

• Clinical guidelines emphasize lifestyle changes and medication for coronary heart disease (CHD) patients.
• Effective risk factor control in CHD patients is challenging, particularly for those with lower educational attainment.

Purpose of the Study:

• To evaluate educational level disparities in the secondary prevention of CHD.
• To analyze inequalities in risk factor target attainment and treatment across different income countries.

Main Methods:

• A cross-sectional clinical audit (SURF CHD II) involving 13,884 CHD patients across 29 countries.
• Data collected during routine clinical visits from 2019-2022.
• Logistic regression used to assess differences in target attainment and treatment based on educational level, stratified by country income.

Main Results:

• Overall poor attainment of guideline-defined risk factor targets in CHD patients.
• Patients with higher education were more likely to achieve targets for smoking, LDL cholesterol, and physical activity.
• Higher education correlated with increased use of cardioprotective medications and participation in cardiac rehabilitation.

Conclusions:

• Significant health inequities exist in CHD secondary prevention, with higher educational attainment associated with better risk factor management.
• The relationship between education and secondary prevention outcomes varies by country income level.
• Global efforts are needed to improve risk factor target attainment and cardiac rehabilitation participation in all CHD patients.