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Best practice for prevention and treatment of cardiovascular disease through an equity lens : a review
journal contribution
posted on 2010-10-01, 00:00 authored by Alison Beauchamp, Anna PeetersAnna Peeters, A Tonkin, Gavin TurrellBackground Despite declining rates of cardiovascular disease (CVD) mortality in developed countries, lower socioeconomic groups continue to experience a greater burden of the disease. There are now many evidence-based treatments and prevention strategies for the management of CVD and it is essential that their impact on the more disadvantaged group is understood if socioeconomic inequalities in CVD are to be reduced.
Aims To determine whether key interventions for CVD prevention and treatment are effective among lower socioeconomic groups, to describe barriers to their effectiveness and the potential or actual impact of these interventions on the socioeconomic gradient in CVD.
Methods Interventions were selected from four stages of the CVD continuum. These included smoking reduction strategies, absolute risk assessment, cardiac rehabilitation, secondary prevention medications, and heart failure self-management programmes. Electronic searches were conducted using terms for each intervention combined with terms for socioeconomic status (SES).
Results Only limited evidence was found for the effectiveness of the selected interventions among lower SES groups and there was little exploration of socioeconomic-related barriers to their uptake. Some broad themes and key messages were identified. In the majority of findings examined, it was clear that the underlying material, social and environmental factors associated with disadvantage are a significant barrier to the effectiveness of interventions.
Conclusion Opportunities to reduce socioeconomic inequalities occur at all stages of the CVD continuum. Despite this, current treatment and prevention strategies may be contributing to the widening socioeconomic-CVD gradient. Further research into the impact of best-practice interventions for CVD upon lower SES groups is required.
Aims To determine whether key interventions for CVD prevention and treatment are effective among lower socioeconomic groups, to describe barriers to their effectiveness and the potential or actual impact of these interventions on the socioeconomic gradient in CVD.
Methods Interventions were selected from four stages of the CVD continuum. These included smoking reduction strategies, absolute risk assessment, cardiac rehabilitation, secondary prevention medications, and heart failure self-management programmes. Electronic searches were conducted using terms for each intervention combined with terms for socioeconomic status (SES).
Results Only limited evidence was found for the effectiveness of the selected interventions among lower SES groups and there was little exploration of socioeconomic-related barriers to their uptake. Some broad themes and key messages were identified. In the majority of findings examined, it was clear that the underlying material, social and environmental factors associated with disadvantage are a significant barrier to the effectiveness of interventions.
Conclusion Opportunities to reduce socioeconomic inequalities occur at all stages of the CVD continuum. Despite this, current treatment and prevention strategies may be contributing to the widening socioeconomic-CVD gradient. Further research into the impact of best-practice interventions for CVD upon lower SES groups is required.
History
Journal
European journal of cardiovascular prevention and rehabilitationVolume
17Issue
5Pagination
599 - 606Publisher
Sage PublicationsLocation
London, EnglandPublisher DOI
ISSN
1741-8267eISSN
2047-4881Language
engPublication classification
C1.1 Refereed article in a scholarly journalCopyright notice
2010, Sage PublicationsUsage metrics
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cardiovascular diseaseclinical guidelinespreventionpublic health policysmokingsocioeconomic statusScience & TechnologyLife Sciences & BiomedicineCardiac & Cardiovascular SystemsCardiovascular System & CardiologyTOBACCO-CONTROL POLICIESFREE NICOTINE PATCHESACUTE MYOCARDIAL-INFARCTIONCORONARY-HEART-DISEASESMOKING-CESSATIONMANAGEMENT PROGRAMCARDIAC REHABILITATIONCIGARETTE CONSUMPTIONRISK PROFILEHEALTH
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