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Sex differences in the relationship between socioeconomic status and cardiovascular disease: a systematic review and meta-analysis

Backholer, Kathryn, Peters, Sanne AE, Bots, Sophie H, Peeters, Anna, Huxley, Rachel R and Woodward, Mark 2017, Sex differences in the relationship between socioeconomic status and cardiovascular disease: a systematic review and meta-analysis, Journal of epidemiology and community health, vol. 71, no. 6, pp. 550-557, doi: 10.1136/jech-2016-207890.

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Title Sex differences in the relationship between socioeconomic status and cardiovascular disease: a systematic review and meta-analysis
Author(s) Backholer, Kathryn
Peters, Sanne AE
Bots, Sophie H
Peeters, AnnaORCID iD for Peeters, Anna orcid.org/0000-0003-4340-9132
Huxley, Rachel R
Woodward, Mark
Journal name Journal of epidemiology and community health
Volume number 71
Issue number 6
Start page 550
End page 557
Total pages 8
Publisher BMJ Group
Place of publication London, Eng.
Publication date 2017-06
ISSN 0143-005X
1470-2738
Keyword(s) CORONARY HEART DISEASE
Epidemiology of cardiovascular disease
META ANALYSIS
SOCIAL INEQUALITIES
STROKE
Summary BACKGROUND: Low socioeconomic status (SES) is a known risk factor for cardiovascular disease (CVD) but whether its effects are comparable in women and men is unknown.

METHODS: PubMed MEDLINE was systematically searched. Studies that reported sex-specific estimates, and associated variability, of the relative risk (RR) for coronary heart disease (CHD), stroke or CVD according to a marker of SES (education, occupation, income or area of residence), for women and men were included. RRs were combined with those derived from cohort studies using individual participant data. Data were pooled using random effects meta-analyses with inverse variance weighting. Estimates of the ratio of the RRs (RRR), comparing women with men, were computed.

RESULTS: Data from 116 cohorts, over 22 million individuals, and over 1 million CVD events, suggest that lower SES is associated with increased risk of CHD, stroke and CVD in women and men. For CHD, there was a significantly greater excess risk associated with lower educational attainment in women compared with men; comparing lowest with highest levels, the age-adjusted RRR was 1.24 (95% CI 1.09 to 1.41) and the multiple-adjusted RRR was 1.34 (1.09 to 1.63). For stroke, the age-adjusted RRR was 0.93 (0.72 to 1.18), and the multiple-adjusted was RRR 0.79 (0.53 to 1.19). Corresponding results for CVD were 1.18 (1.03 to 1.36), 1.23 (1.03 to 1.48), respectively. Similar results were observed for other markers of SES for all three outcomes.

CONCLUSIONS: Reduction of socioeconomic inequalities in CHD and CVD outcomes might require different approaches for men and women.
Language eng
DOI 10.1136/jech-2016-207890
Field of Research 111799 Public Health and Health Services not elsewhere classified
1117 Public Health And Health Services
1604 Human Geography
Socio Economic Objective 920102 Cancer and Related Disorders
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, BMJ Publishing Group
Persistent URL http://hdl.handle.net/10536/DRO/DU:30090308

Document type: Journal Article
Collection: School of Health and Social Development
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