Department of Public Health, University of Helsinki, 00014 Helsinki, Finland.
Int J Environ Res Public Health. 2021 Sep 27;18(19):10148. doi: 10.3390/ijerph181910148.
There are persisting socioeconomic differences in cardiovascular diseases, but studies on socioeconomic differences in the initiation of cardiovascular medication are scarce. This study examined the associations between multiple socioeconomic circumstances and cardiovascular medication. The Helsinki Health Study baseline survey (2000-2002) of 40-60-year-old employees was linked with cardiovascular medication data from national registers. The analyses included 5805 employees concerning lipid medication and 4872 employees concerning hypertension medication. Medication purchases were followed for 10 years. The analyses were made using logistic regression, and the odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated for childhood, conventional and material socioeconomic circumstances. Low parental education showed an association with lipid medication among women only (OR 1.34, 95% CI 1.11-1.61), whereas childhood economic difficulties showed more widespread associations. Low education and occupational class were associated with an increased risk of both hypertension (education: OR 1.58, 1.32-1.89; occupational class: 1.31, 1.08-1.59) and lipid medication (education: 1.34, 1.12-1.61; occupational class: 1.38, 1.13-1.67). Rented housing (1.35, 1.18-1.54 for hypertension medication; 1.21, 1.05-1.38 for lipid medication) and current economic difficulties (1.59, 1.28-1.98 for hypertension medication; 1.35, 1.07-1.71 for lipid medication) increased the risk. Several measures of socioeconomic circumstances acting at different stages of the life course were associated with cardiovascular medication, with individuals in disadvantageous socioeconomic circumstances having elevated risks.
心血管疾病在社会经济方面一直存在差异，但关于心血管药物治疗起始的社会经济差异的研究却很少。本研究探讨了多种社会经济状况与心血管药物治疗之间的关联。该研究将赫尔辛基健康研究（2000-2002 年）的基线调查（40-60 岁的员工）与全国登记处的心血管药物数据相联系。分析包括 5805 名服用降脂药物的员工和 4872 名服用高血压药物的员工。对药物购买情况进行了 10 年的随访。使用逻辑回归进行分析，并计算了童年、传统和物质社会经济状况的比值比（OR）及其 95%置信区间（CI）。低父母教育与女性服用降脂药物有关（OR1.34，95%CI1.11-1.61），而童年经济困难则与更广泛的关联有关。低教育程度和职业阶层与高血压（教育：OR1.58，1.32-1.89；职业阶层：1.31，1.08-1.59）和降脂药物（教育：1.34，1.12-1.61；职业阶层：1.38，1.13-1.67）的风险增加有关。租用住房（高血压药物：1.35，1.18-1.54；降脂药物：1.21，1.05-1.38）和当前经济困难（高血压药物：1.59，1.28-1.98；降脂药物：1.35，1.07-1.71）增加了风险。生命历程不同阶段的几种社会经济状况衡量标准与心血管药物治疗相关，处于不利社会经济地位的个体风险更高。
