Helmert U, Herman B, Joeckel K H, Greiser E, Madans J
Department of Epidemiology, Bremen Institute for Prevention Research and Social Medicine, FRG.
J Epidemiol Community Health. 1989 Mar;43(1):37-42. doi: 10.1136/jech.43.1.37.
The relationship between social class and seven important risk factors for coronary heart disease has been evaluated utilising data from the German Cardiovascular Prevention Study baseline survey. Of German residents aged 25 to 69 years, 16,430 were randomly selected from both the six intervention regions and the Federal Republic of Germany to undergo the screening procedures between 1984 and 1986. Among males the prevalence of cigarette smoking and lack of physical activity was associated with social class. For females, overweight and physical activity demonstrated a strong social gradient. No relationship existed between social class and hypercholesterolaemia. The prevalence of Type A behaviour was significantly higher for the upper social classes. The number of CHD risk factors per study subject increased with decreasing social class. Predicted cardiovascular mortality was clearly higher for the lower social class among males in general and for females younger than 60 years. These findings point to the need for risk factor intervention strategies focusing more on the lower social classes in order to achieve more adequate prevention of coronary heart disease.
利用德国心血管疾病预防研究基线调查的数据,对社会阶层与冠心病七个重要风险因素之间的关系进行了评估。在25至69岁的德国居民中,1984年至1986年间从六个干预地区和德意志联邦共和国随机选取了16430人接受筛查程序。在男性中,吸烟率和缺乏体育活动与社会阶层有关。对于女性,超重和体育活动呈现出强烈的社会梯度。社会阶层与高胆固醇血症之间不存在关联。A 型行为的患病率在社会上层明显更高。每个研究对象的冠心病风险因素数量随着社会阶层的降低而增加。总体而言,男性以及60岁以下女性中,社会阶层较低者的预测心血管死亡率明显更高。这些发现表明,需要制定更侧重于社会阶层较低人群的风险因素干预策略,以更充分地预防冠心病。