Table 6.
Results from studies examining ideal cardiovascular health (CVH) in relation to composite measures of socioeconomic status (SES)*.
| Reference | Country (study/setting) | Study design | N | Sample description | Ideal CVH measure† | Covariate adjustment | Main finding | Quality score‡ |
|---|---|---|---|---|---|---|---|---|
|
| ||||||||
| High-Income Countries | ||||||||
| Boylan, et al., 2017 [32] | USA (MIDUS) | Longitudinal (9–10y) | 1,012 | • Male & female • Ages 35–86y |
Total score (0–14) | Age, sex, race, baseline smoking, physical activity, hypertension, diabetes, cholesterol medication use, chronic health conditions, neighborhood SES Age, sex, race, individual SES, neighborhood SES, baseline smoking, physical activity, hypertension, diabetes, cholesterol medication use, and chronic health conditions |
Greater SES associated with higher ideal CVH scores Greater neighborhood-level SES associated with higher ideal CVH scores |
11 |
| De Moraes, et al., 2019 [35] | USA (MESA) | Cross-sectional | 6,792 | • Male & female • White, Black, Latinx & Chinese Am. • CVD-free • Ages 45–84y |
Poor (≤7/14) | Age, education, income, occupation, study site | Lower SES associated with greater likelihood of poor CVH | 9 |
| Empana, et al., 2016 [79] | France (Paris) | Cross-sectional | 8,916 | • Male & female • Ages 50–75y |
Categorical (≥5 vs. ≤2/7) | Age, alcohol consumption, depressive symptoms, education, self-perceived health | Higher levels of deprivation associated with lower likelihood of ideal CVH | 10 |
| Matthews, et al., 2017 [38] | USA (Pittsburgh) | Longitudinal (17–28y) | 307 | • Male • White & Black • Ages 13–16y |
Total score (0–14) | High risk screening status, race, adult SES | No evidence of association between family SES in adolescence and adult CVH scores; Higher SES in adulthood associated with higher CVH scores | 11 |
| Savelieva, et al., 2017 [46] | Finland (Young Finns) | Longitudinal (32y) | 697 | • Male & female • Ages 3–18y |
Total score (0–7) | Age, sex, adult SES, childhood CV risk factors, chronic conditions | Greater childhood SES associated with higher ideal CVH scores in adulthood; Upward socioeconomic mobility from childhood to adulthood associated with higher ideal CVH scores in adulthood | 12 |
| Low- and Middle-Income Countries | ||||||||
| Bi, et al., 2015 [49] | China (NCD) | Cross-sectional | 96,121 | • Male & female • Ages ≥20y |
Categorical (≥6 vs. ≤1/7) | Age, sex, education, medical insurance, urbanicity | Lower economic development associated with greater likelihood of ideal CVH | 11 |
| Oliveira, et al., 2021 [57] | Brazil (Pelotas) | Repeated cross-sectional (4y) | 2,236 | • Male & female • Age 18 |
Ideal (≥4/7) | Sex, skin color | Mixed associations between socioeconomic position and likelihood of ideal CVH by sex | 10 |
| Ren, et al., 2016 [56] | China (Shandong) | Cross-sectional | 15,350 | • Male & female • Ages 18–69y |
Ideal (≥5/7) | Age, income, education | Greater SES associated with greater likelihood of ideal CVH | 12 |
*
For more information about each study, including full results, see Supplemental Table S5.
†
Studies assessed ideal CVH using a 7-point measure reflecting participants total number of ideal metrics, or using a 14-point measure that scored metrics as poor (0), intermediate (1) or ideal (2).
‡
Study quality scores ranged from 0 to 13, with higher values indicating higher quality (i.e. lower risk of bias).MESA = multi-ethnic study of atherosclerosis; MIDUS = midlife in the United States study; NCD = China non-communicable disease surveillance 2010.