Lifestyle and Cardiovascular Risk Factors by Educational Attainment in a Mediterranean Setting: A Cross-Sectional...

Socioeconomic inequalities in cardiovascular risk persist despite declining mortality. We examined the prevalence of cardiovascular risk factors and lifestyle behaviors across educational levels in men and women from a Mediterranean population.

Cross-sectional analysis of adults aged 35-74 years from a population-based sample in north-eastern Spain. Risk factors and lifestyle were assessed with standardized measurements and validated questionnaires. Educational attainment was categorized as primary, secondary, or university. Analyses were sex-stratified; age-adjusted linear and logistic regression models were applied.

We included 943 adults (52.3% women). Among men, secondary and university education (vs. primary) were associated with lower LDL-cholesterol [β -11.76 (95% CI -21.68 to -1.83) and -17.83 (-28.03 to -7.63) mg/dL], lower odds of hypercholesterolemia [OR = 0.43 (0.20-0.90) for both], smoking [OR = 0.57 (0.33-0.97) and 0.53 (0.30-0.95)], and higher odds of high Mediterranean diet adherence [OR = 2.08 (1.04-4.16) and 3.05 (1.51-6.14)]. Among women, secondary and university education (vs. primary) were associated with lower body mass index [β -1.81 (-2.85 to -0.77) and -2.52 (-3.63 to -1.40) kg/m²] and lower odds of overweight/obesity [OR = 0.47 (0.29-0.76) and 0.34 (0.20-0.56)]. Lower odds of hypertension [OR = 0.44 (0.22-0.87)] and high Mediterranean diet adherence [OR = 2.14 (1.12-4.09)] were also more likely in university-educated women.

Higher educational attainment was associated with healthier lifestyles and more favorable cardiometabolic profiles. Educational gradients were broader in women-spanning adiposity, blood pressure, glycemia, and lipidemia-whereas, in men, they mainly affected lipidemia and diet.