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Higher income associated with increased risk for CAD
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Among a cohort of adults in the Middle East, those with higher income, those living in rural areas and those who are unemployed had a higher risk for CAD, according to a study.
“The association between socioeconomic factors and CAD has been supported by numerous epidemiological studies. Since the mid-1970s, the rate of major CVD and death has shifted from high-income to low-income countries,” Amin Daoulah, MD, of the cardiology department at King Faisal Specialist Hospital & Research Centre, Saudi Arabia, and colleagues wrote. “Despite the fact that the risk factor burden was lower in low-income countries compared with high-income countries, the rates of major CVD and death were higher in the low-income countries.”
Daoulah and colleagues collected data on 1,068 consecutive patients undergoing coronary angiography at five hospitals in Saudi Arabia and the United Arab Emirates.
Significant CAD was defined as more than 70% luminal stenosis in a major epicardial vessel, and multivessel disease was defined as the presence of more than one significant CAD.
Of the study participants, 56% had diabetes, 60% had hypertension and 43% had a history of CAD; 74% were from urban communities and 26% were from rural communities.
Those from rural communities were older and more likely to have diabetes, hypertension, dyslipidemia, CAD and PCI. There were also significant differences in income level, employment status and indication for angiography.
Patients living in a rural area were more likely to have significant CAD (adjusted OR = 2.4; 95% CI, 1.47-3.97), multivessel disease (aOR = 1.76; 95% CI, 1.18-2.63) and left main disease (aOR = 1.17; 95% CI, 1.04-2.82), after adjustment for baseline factors. Unemployment was associated with an increased risk in CAD (aOR = 2.21; 95% CI, 1.27-3.85).
Higher income was associated with increased risk for CAD (aOR = 6.97; 95% CI, 2.3-21.09) and multivessel disease (aOR = 2.49; 95% CI, 1.11-5.56).
“The well-accepted socioeconomic-CAD gradient might not be applicable to all regions of the world,” the researchers wrote. “We suggest that the interpretation of socioeconomic status should take in account the differences in risk factors between different ethnicities and the difference of cultural lifestyle in individuals from the same socioeconomic status. The underpinnings of these associations (eg, pathophysiologic factors, access to care and system-wide determinants of quality) require further study.” – by Cassie Homer
Disclosures: The authors report no relevant financial disclosures.
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