累积的社会劣势和心血管疾病负担和死亡率
Omar Hahad1,2, Donya A Gilan3,4, Julian Chalabi5
1Department of Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany.
European journal of preventive cardiology
|September 18, 2023
概括
低社会经济地位 (SES) 显著增加心血管疾病 (CVD) 的风险和死亡率,即使有全民医疗保健. 教育和职业是关键因素,突出了心血管健康的社会决定因素.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 健康的社会决定因素
背景情况:
- 社会经济地位 (SES) 是已知的健康结果的决定因素.
- 了解累积社会劣势对心血管疾病 (CVD) 和死亡率的具体影响对于公共卫生干预至关重要.
研究的目的:
- 调查累积社会劣势与心血管负担和死亡率在大量普通人口队列之间的关联.
- 确定SES的特定维度,这些维度对心脏病风险和死亡率贡献最大.
主要方法:
- 利用了来自古登堡健康研究 (n=15,010) 的横截面和纵向数据.
- 通过验证的问卷来评估个人SES,包括教育,职业和家庭净收入.
- 分析了使用后勤和危险回归模型与流行和发病心血管疾病 (CVD) 和全因死亡率的关联.
主要成果:
- 在10年的随访中,低SES与患有常见心脏病的更高几率 (OR1.19) 和发生心脏病的风险增加 (OR1.68) 和全因死亡率 (HR1.86) 显著相关.
- 在5年的随访中,低SES与心血管 (HR 5.36) 和全因死亡率 (HR 2.23) 的大幅增加有关.
- 教育和职业分数显示,与心血管疾病风险和死亡率的关联比家庭净收入更强.
结论:
- 累积的社会劣势,特别是较低的教育和职业,独立地与心血管疾病风险和死亡率的增加有关.
- 尽管普遍获得医疗保健,但这些发现仍然存在,这强调了社会决定因素对心血管健康的影响.
- 公共卫生战略应解决社会不平等问题,以减轻心血管疾病负担.
更多相关视频
相关概念视频
Coronary Artery Disease I: Introduction
20
Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
20
Psychoneuroimmunology: Cardiovascular Disease
49
Psychoneuroimmunology (PNI) is a multidisciplinary field that examines how psychological factors, particularly stress, interact with the immune system and impact physical health. Research in PNI has shown that chronic or traumatic stress can disrupt both the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. These disruptions contribute to serious health conditions, including cardiovascular diseases.
A key area of focus in PNI is the relationship between stress and coronary...
A key area of focus in PNI is the relationship between stress and coronary...
49
Imbalances in Cardiac Output
1.4K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.4K
Assessment of the Cardiovascular System I: Subjective Data
366
A thorough health history and physical assessment are essential for identifying cardiovascular disease (CVD) symptoms and distinguishing them from other health issues.
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
366
Coronary Artery Disease II: Pathophysiology
12
Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
12
Bias in Epidemiological Studies
343
Biases can arise at various stages of research, from study design and data collection to analysis and interpretation. Recognizing and addressing these biases is essential to ensure the validity and reliability of epidemiological findings.Broadly speaking, biases in epidemiology fall into three main categories: selection bias, information bias, and confounding. A more detailed description of possible biases is:
343


