Income, education inequities impact sudden cardiac death risk
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Key takeaways:
- People with lower income and education had an increased risk for sudden cardiac death compared with people with higher income and education.
- The differences were not explained by modifiable risk factors.
Income and education had an inverse relationship with the risk for sudden cardiac death that was not explained by modifiable risk factors, researchers reported.
“Sudden death of cardiac causes is among the leading causes of death in the general population and predicting who is at high risk is difficult,” Peder Emil Warming, MD, of the department cardiology at Copenhagen University Hospital in Denmark, and colleagues wrote in the European Journal of Preventive Cardiology. “Finding people or groups at high risk is important to improve prevention.”
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To determine the effect of income and education level on the incidence of sudden cardiac death, as well as the impact of modifiable mediating risk factors, Warming and colleagues analyzed information from 10,006 participants (median age at baseline, 61 years; 56% women) in the Copenhagen City Heart Study in Denmark.
Researchers followed up with participants from 1993 to 2016.
They collected sociodemographic information, including education, occupation and income, from self-reported questionnaires that participants completed at baseline. Participants were stratified by education (elementary, apprenticeship, short education and long education) and by income level (low, medium or high).
Warming and colleagues found that people with an elementary level education had a higher incidence of sudden cardiac death compared with individuals with a long education (incidence rate ratio [IRR] = 2.48; 95% CI, 1.86-3.31).
In addition, individuals with low income had a higher incidence of sudden cardiac death compared with individuals with high income (IRR = 2.34; 95% CI, 1.85-2.96).
Researchers also said modifiable risk factors, including smoking, physical activity and BMI, only accounted for a small portion of the risk differences in the association between education and sudden cardiac death.
“The emphasis should be on modifiable preventive measures to address socioeconomic inequalities in sudden cardiac death, with a focus on the disadvantaged population, ranging from individual-level measures to political strategies,” Warming and colleagues wrote.
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