Exploring the association between low socioeconomic status and cardiovascular disease risk in healthy Greeks, in the years of financial crisis (2002-2012): The ATTICA study

Background: Despite recent declines in mortality, cardiovascular disease (CVD) remains the leading cause of death in Europe today. Given the fact that many of the biological risk factors have already been identified, researchers still search for different modifiable factors that may influence CVD risk, among which SES gathers a great part of interest. Aims: To explore the effect of low socioeconomic status (SES) on a 10-year cardiovascular disease (CVD) incidence, in the years of financial crisis. Methods: This population-based study was carried out in the province of Attica, where Athens is a major metropolis. During 2001-2002, information from 1528 men (18-87 years old) and 1514 women (18-89 years old) was collected. Educational level and annual income were used to define their SES. After a 10-year of follow-up period (2002-2012), CVD incidence was recorded. Results: Low compared to high SES class, at the ages above 45 years, was independently associated with increased 10-year CVD incidence [adjusted odds ratio and 95% confidence interval: 2.7 (1.5, 4.9)] but not among the younger participants. SES was also negatively associated with psychological components (all p-values < 0.001), diabetes mellitus (p = 0.002), obesity (p = 0.087) and physical activity (p = 0.056). Conclusion: There is evidence for a consistent reverse relation between SES and the incidence of CVD and for higher CVD risk factors among less privileged individuals. The striking differences by SES underscore the critical need to improve screening, early detection, and treatment of CVD-related conditions for people of lower SES, emphasizing in the middle-aged groups. (C) 2016 Elsevier Ireland Ltd. All rights reserved.