MedicalResearch.com Interview with:
Sanne Peters, PhD
Research Fellow in Epidemiology
The George Institute for Global Health
University of Oxford
Oxford United Kingdom
MedicalResearch.com: What is the background for this study?
Response: People from disadvantaged backgrounds are, on average, at greater risk of cardiovascular diseases than people with more affluent backgrounds. Some studies have suggested that these socioeconomic inequalities in cardiovascular disease are more consistent and stronger in women than in men. However, the literature is inconsistent.
MedicalResearch.com: What are the main findings?
Response: In our review of data on 22 million people from 116 studies in North America, Europe, Asia and Australasia, we found that a lower socioeconomic status, compared to a higher, is associated with a higher risk of cardiovascular disease for both sexes. However, women from more disadvantaged backgrounds were 25% more likely to suffer from coronary heart disease than similarly affected men. There was no sex difference for stroke, however.
MedicalResearch.com: What should readers take away from your report?
Response: Our study demonstrates that disproportionally more disadvantaged women are suffering from heart disease than their male counterparts, which is concerning. The sex difference was unlikely to be caused by other major risk factors for cardiovascular disease like smoking, high blood pressure. It is more likely that differences between men and women in the identification of heart disease risk and subsequent management explain why this is happening.
Heart disease occurs about 5 to 10 years earlier for men compared to women, so men are more aware and more likely to go to their doctor and start treatment if they have high blood pressure or high cholesterol. Women, in contrast, are less likely to initiate preventative treatment for heart disease and we also know that people with lower socioeconomic status are less likely to seek and initiate preventative treatment. These combined may explain the sex difference. This is unfortunate as much of the risk can be avoided by lifestyle changes and medical treatment.
We need to examine why the impact of a lower socioeconomic status on the risk of heart disease is greater in women than in men. Understanding why this is happening would help to make sure women, too, are able to access lifesaving treatment.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: This research shows that there is a clear need for sex specific research to discover why disproportionally more women than men are suffering from heart disease in disadvantaged communities. This will help to deliver prevention and treatment programs that will reduce the burden of cardiovascular disease around the world. However, this is beyond just closing the gender gap. We also need to ensure that everyone has the best possible health outcomes and treatment. It should not be dependent on your level of education or where you happen to live.
MedicalResearch.com: Is there anything else you would like to add?
Response: The George Institute for Global Health has joined a global call for women’s health policies to prioritise non-communicable diseases, such heart disease, stroke and diabetes, which are the leading causes of premature death in most countries. The institute produced a policy paper called, “Women’s Health: A New Global Agenda”, which also highlighted the need for seeks the rebalancing of the concept of women’s health to highlight non-communicable diseases and promotes sex-specific medicine.
The study was supported through funding from the NHMRC and the National Heart Foundation of Australia.
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Sex differences in the relationship between socioeconomic status and cardiovascular disease: a systematic review and meta-analysis
Kathryn Backholer, Sanne A E Peters, Sophie H Bots, Anna Peeters, Rachel R Huxley,Mark Woodward
J Epidemiol Community Health jech-2016-207890Published Online First: 14 December 2016 doi:10.1136/jech-2016-207890
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