The effect of deprivation on coronary heart disease mortality rate

Theocharidou, Lambrini; Mulvey, Matt

doi:10.1093/biohorizons/hzy007

Cited by 6 publications

(7 citation statements)

References 17 publications

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“…The demographic findings that a history of previous cardiovascular events is more common in older male individuals with multiple other comorbidities are already well established . Importantly, we were also able to demonstrate that in this surgical population, increasing levels of socioeconomic deprivation were more common in those with a previous cardiovascular event, in agreement with existing findings in the general population . In accordance with previous population-level mortality data from the UK, we found liver disease, kidney failure, and congestive heart failure were the 3 comorbidities associated with the greatest fold increase in 30-day mortality, followed by peripheral vascular disease, dementia, and cardiac arrhythmias …”

Section: Discussionsupporting

confidence: 91%

Risk of Mortality Following Surgery in Patients With a Previous Cardiovascular Event

Chalitsios,

Luney,

Lindsay

et al. 2024

JAMA Surg

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ImportanceThere is a lack of consensus regarding the interval of time-dependent postoperative mortality risk following acute coronary syndrome or stroke.ObjectiveTo determine the magnitude and duration of risk associated with the time interval between a preoperative cardiovascular event and 30-day postoperative mortality.Design, Setting, and ParticipantsThis is a longitudinal retrospective population-based cohort study. This study linked data from the Hospital Episode Statistics for National Health Service England, Myocardial Ischaemia National Audit Project and the Office for National Statistics mortality registry. All adults undergoing a National Health Service–funded noncardiac, nonneurologic surgery in England between April 1, 2007, and March 31, 2018, registered in Hospital Episode Statistics Admitted Patient Care were included. Data were analyzed from July 2021 to July 2022.ExposureThe time interval between a previous cardiovascular event (acute coronary syndrome or stroke) and surgery.Main Outcomes and MeasuresThe primary outcome was 30-day all-cause mortality. Secondary outcomes were postoperative mortality at 60, 90, and 365 days. Multivariable logistic regression models with restricted cubic splines were used to estimate adjusted odds ratios.ResultsThere were 877 430 patients with and 20 582 717 without a prior cardiovascular event (overall mean [SD] age, 53.4 [19.4] years; 11 577 157 [54%] female). Among patients with a previous cardiovascular event, the time interval associated with increased risk of postoperative mortality was surgery within 11.3 months (95% CI, 10.8-11.7), with subgroup risks of 14.2 months before elective surgery (95% CI, 13.3-15.3) and 7.3 months for emergency surgery (95% CI, 6.8-7.8). Heterogeneity in these timings was noted across many surgical specialties. The time-dependent risk intervals following stroke and myocardial infarction were similar, but the absolute risk was greater following a stroke. Regarding surgical urgency, the risk of 30-day mortality was higher in those with a prior cardiovascular event for emergency surgery (adjusted hazard ratio, 1.35; 95% CI, 1.34-1.37) and an elective procedure (adjusted hazard ratio, 1.83; 95% CI, 1.78-1.89) than those without a prior cardiovascular event.Conclusions and RelevanceIn this study, surgery within 1 year of an acute coronary syndrome or stroke was associated with increased postoperative mortality before reaching a new baseline, particularly for elective surgery. This information may help clinicians and patients balance deferring the potential benefits of the surgery against the desire to avoid increased mortality from overly expeditious surgery after a recent cardiovascular event.

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Section: Discussionsupporting

confidence: 91%

Risk of Mortality Following Surgery in Patients With a Previous Cardiovascular Event

Chalitsios,

Luney,

Lindsay

et al. 2024

JAMA Surg

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“…People living in socioeconomic deprived areas had multiple lifestyle risk behaviours, experience high CVD rates, and premature mortality 46 , 51 , 52 . In a study conducted in the UK, areas with higher socioeconomic deprivation had high coronary heart disease mortality 53 . Populations with socioeconomic deprivation are more likely to smoke, have a poor diet, and not exercise enough 52 .…”

Section: Discussionmentioning

confidence: 99%

Effects of lifestyle risk behaviour clustering on cardiovascular disease among UK adults: latent class analysis with distal outcomes

Islam

Maddison

2022

Sci Rep

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Lifestyle risk behaviours such as smoking, physical inactivity, and unhealthy diet account for a considerable disease burden globally. These risk behaviours tend to cluster within an individual, which could have detrimental health effects. In this study, we aimed to examine the clustering effect of lifestyle risk behaviours on cardiovascular disease (CVD) and CVD risk among adults in the United Kingdom (UK). We performed a latent class (LC) analysis with distal outcomes using the UK Biobank baseline (2006–2010) data. First, we estimated LC measurement models, followed by an auxiliary model conditional on LC variables. We reported continuous (mean difference—MD) and binary (odds ratio—OR) outcomes with 95% confidence intervals. We included 283,172 and 174,030 UK adults who had data on CVD and CVD risk, respectively. Multiple lifestyle risk behaviour clustering (physically inactive, poor fruit & vegetable intake, high alcohol intake, and prolonged sitting) had a 3.29 mean increase in CVD risk compared to high alcohol intake. In addition, adults with three risk behaviours (physically inactive, poor fruit & vegetable intake, and high alcohol intake) had 25.18 higher odds of having CVD than those with two risk behaviours (physically inactive, and poor fruit and vegetable intake). Social deprivation, gender and age were also associated with CVD. Individuals' LC membership with two or more lifestyle risk behaviours negatively affects CVD. Interventions targeting multiple lifestyle behaviours and social circumstances should be prioritized to reduce the CVD burden.

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“…The reviewed studies also confirmed a strong association between poverty and heart failure outcomes. 13 examined the effect of socioeconomic depreciation on coronary heart attack mortalities. The findings revealed that areas with high levels of socioeconomic deprivation, especially on income, education, and housing, were more likely to develop adverse outcomes.…”

Section: Resultsmentioning

confidence: 99%

Impact of Socioeconomic Status on Heart Failure

Walia,

Mankoff

2023

Journal of Community Hospital Internal Medicine Perspectives

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Heart failure has emerged as a substantial health burden in the United States in the last few decades. This study examined the hypothesis that socioeconomic factors such as education level, social position, employment status, and poverty have a strong confounding influence on the risk for heart failure. To access relevant data, 12 published studies were retrieved from MEDLINE, Google Scholar, and Web of Science. A cross-sectional analysis of the identified studies confirmed that the four socioeconomic factors predisposed individuals to an elevated risk of heart failure-related complications. Despite their interdependencies, educational level, employment status, social position, and poverty independently confounded cardiovascular risk among individuals. Notably, individuals from households with low education were at a higher risk of these diseases. At the same time, households without employed family members were less likely to report cases of heart failure than those with low socioeconomic status. Additionally, individuals from disadvantaged backgrounds faced a greater risk for heart failure complications. The findings from this study found a strong association between socioeconomic status and heart failure risks.

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The effect of deprivation on coronary heart disease mortality rate

Cited by 6 publications

References 17 publications

Risk of Mortality Following Surgery in Patients With a Previous Cardiovascular Event

Risk of Mortality Following Surgery in Patients With a Previous Cardiovascular Event

Effects of lifestyle risk behaviour clustering on cardiovascular disease among UK adults: latent class analysis with distal outcomes

Impact of Socioeconomic Status on Heart Failure

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