University of Alberta, Alberta, Edmonton, AB T6R2R6, Canada.
Nat Rev Cardiol. 2009 Nov;6(11):712-22. doi: 10.1038/nrcardio.2009.163. Epub 2009 Sep 22.
Socioeconomic status (SES) refers to an individual's social position relative to other members of a society. Low SES is associated with large increases in cardiovascular disease (CVD) risk in men and women. The inverse association between SES and CVD risk in high-income countries is the result of the high prevalence and compounding effects of multiple behavioral and psychosocial risk factors in people of low SES. However, strong and consistent evidence shows that parental SES, childhood and early-life factors, and inequalities in health services also contribute to elevated CVD risk in people of low SES who live in high-income countries. In addition, place of residence can affect CVD risk, although the data on the influence of wealth distribution and work-related factors are inconsistent. Studies on the effects of SES on CVD risk in low-income and middle-income countries is scarce, but evidence is emerging that the increasing wealth of these countries is beginning to lead to replication of the patterns seen in high-income countries. Clinicians should address the association between SES and CVD by incorporating SES into CVD risk calculations and screening tools, reducing behavioral and psychosocial risk factors via effective and equitable primary and secondary prevention, undertaking health equity audits to assess inequalities in care provision and outcomes, and by use of multidisciplinary teams to address risk factors over the life course.
社会经济地位（SES）是指个体相对于社会其他成员的社会地位。低 SES 与男性和女性心血管疾病（CVD）风险的大幅增加有关。高收入国家 SES 与 CVD 风险之间的反比关系是由于 SES 较低的人群中多种行为和心理社会风险因素的普遍存在和累积效应所致。然而，强有力和一致的证据表明，父母 SES、儿童和早期生活因素以及卫生服务方面的不平等也导致生活在高收入国家的 SES 较低的人群 CVD 风险升高。此外，居住地也会影响 CVD 风险，尽管有关财富分配和与工作相关因素影响的数据不一致。关于 SES 对低收入和中等收入国家 CVD 风险影响的研究很少，但有证据表明，这些国家财富的增加开始导致与高收入国家类似的模式出现。临床医生应通过将 SES 纳入 CVD 风险计算和筛查工具、通过有效和公平的初级和二级预防来减少行为和心理社会风险因素、进行健康公平审计以评估护理提供和结果方面的不平等以及使用多学科团队来解决整个生命周期的风险因素，来解决 SES 与 CVD 之间的关联。
