Time trends in cardiovascular risk factors across levels of education in a general population

• Published in: European Journal of Preventive Cardiology
• Main Authors: Hagen, A, Eggen, AE, Hanssen, TA, Lappegard, KT, Lochen, ML, Njolstad, I, Wilsgaard, T, Hopstock, LA
• Format: Article in Journal/Newspaper
• Language: English
• Published: Oxford University Press (OUP) 2022
• Subjects: Cardiology and Cardiovascular Medicine; Epidemiology; Norway; Northern Norway
• Online Access: http://dx.doi.org/10.1093/eurjpc/zwac056.104; https://academic.oup.com/eurjpc/article-pdf/29/Supplement_1/zwac056.104/43681436/zwac056.104.pdf

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Northern Norway Health Authority Background Favourable changes over time in population cardiovascular disease (CVD) risk has not benefitted all socioeconomic groups equally. Social inequality in health also exists in high-income countries with an egalitarian welfare system. Purpose We aimed to study CVD risk factors across educational groups over time in a Norwegian general population. Methods We used multivariable linear regression and generalised estimating equation models with age-adjusted means and proportions to examine CVD risk (smoking, physical activity level, obesity [body mass index ≥30 kg/m2], blood pressure, total- and low-density lipoprotein [LDL] cholesterol, and total risk of CVD [estimated 10-year risk with NORRISK 2]) across four levels of education: Primary/partly secondary up to 10 years of schooling, upper secondary, tertiary <4 years, tertiary ≥4 years in women and men aged 40-79 years attending a population-based study with two consecutive surveys in 2007-2008 (N=11,941) and 2015-2016 (N=20,322). Results In women, the difference between the lowest and the highest education level in risk factors in 2007-2008 versus 2015-2016 was for smoking 22.0 vs 19.2 percentage points (pp), obesity 8.7 vs 8.8 pp, sedentary physical activity level 10.5 vs 11.5 pp (p=0.012), systolic blood pressure 5.5 vs 3.4 mmHg (p=0.001), total cholesterol 0.2 mmol/L vs no difference (p<0.001), LDL cholesterol 0.3 vs 0.1 mmol/L (p<0.001), and total CVD risk 0.9 vs 1.8 (p<0.001), respectively. In men, the corresponding numbers were for smoking 20.1 vs 16.8 pp, obesity 9.9 vs 12.9 pp, sedentary physical activity level 10 vs 11.5 pp (p=0.027), systolic blood pressure 1.7 vs 1.7 mmHg, total cholesterol 0.2 mmol/L vs no difference (p<0.001), LDL cholesterol 0.1 mmol/L vs no difference (p<0.001), and total CVD risk 1.2 vs 0.9, respectively. No difference across educational levels ...