Multiple Socioeconomic Circumstances and Initiation of Cardiovascular Medication among Ageing Employees

Abstract

There are persisting socioeconomic differences in cardiovascular diseases, but studies on socioeconomic differences in the initiation of cardiovascular medication are scarce. This study examined the associations between multiple socioeconomic circumstances and cardiovascular medication. The Helsinki Health Study baseline survey (2000–2002) of 40–60-year-old employees was linked with cardiovascular medication data from national registers. The analyses included 5805 employees concerning lipid medication and 4872 employees concerning hypertension medication. Medication purchases were followed for 10 years. The analyses were made using logistic regression, and the odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated for childhood, conventional and material socioeconomic circumstances. Low parental education showed an association with lipid medication among women only (OR 1.34, 95% CI 1.11–1.61), whereas childhood economic difficulties showed more widespread associations. Low education and occupational class were associated with an increased risk of both hypertension (education: OR 1.58, 1.32–1.89; occupational class: 1.31, 1.08–1.59) and lipid medication (education: 1.34, 1.12–1.61; occupational class: 1.38, 1.13–1.67). Rented housing (1.35, 1.18–1.54 for hypertension medication; 1.21, 1.05–1.38 for lipid medication) and current economic difficulties (1.59, 1.28–1.98 for hypertension medication; 1.35, 1.07–1.71 for lipid medication) increased the risk. Several measures of socioeconomic circumstances acting at different stages of the life course were associated with cardiovascular medication, with individuals in disadvantageous socioeconomic circumstances having elevated risks.

The Influence of Socioeconomic Status on the Prognosis and Profile of Patients Admitted for Acute Heart Failure during COVID-19 Pandemic: Overestimated Aspects or a Multifaceted Hydra of Cardiovascular Risk Factors?

“…Moreover, people with poor SES are very prone to pseudo-science, to “off the record” non-medical advice and to the “fake-news” phenomenon concerning specific therapies, which can further prevent an early presentation to hospital and adequate treatment, thereby possibly inducing HF decompensation. This aspect is particularly evident during the COVID-19 pandemic period, when less developed countries, with a lower human development index or GDP/capita (mutually interchangeable with a low SES), present lower rates of vaccination and decreased adherence to sanitary preventive measures [ 38 ], a similar pattern also being observed in the case of reduced adherence to cardiometabolic medication or increased prevalence of various cardiovascular risk factors amongst individuals with modest SES [ 39 , 40 ]. Our results showed that residents of rural areas presented more severe systolic disfunction ( p = 0.009) and an increased need for positive inotropic support ( p = 0.0015) compared to urban dwellers; in this situation, delayed medical presentation or low treatment adherence are commonly incriminated risk factors [ 20 ].…”