Sexual dimorphism in socioeconomic differences regarding the risk factors, symptomatology and management of patients with stable coronary artery disease in Poland

Abstract

Background: Relationships between socioeconomic status (SES) and the risk factors, applied treatment and outcomes of patients with coronary artery disease (CAD) have been demonstrated in Western European countries, however analogous evidence is missing from Eastern and Central European countries. The aim of the study was to investigate SES gradients regarding the risk factors, symptoms and management of patients with stable CAD in Poland, separately in men and women.

Methods: We analyzed the data of 2,593 participants of the RECENT study. SES was assessed based on the level of education attainment: university, secondary school or primary school.

Results: Socioeconomic differences in risk profile were most markedly seen in women: lower the education, higher body mass index (p < 0.01), systolic and diastolic blood pressure (p < 0.05), resting heart rate (p < 0.01), and greater prevalence of heart failure (p < 0.05) and dyslipidemia (p < 0.05). Importantly, smoking habit was the most frequent in women who graduated from univer­sity (p < 0.01). In men, socioeconomic gradients were only seen within resting heart rate (p < 0.01), LDL cholesterol level (p < 0.05) and smoking habit (p < 0.05). In both genders, better education was associated with less severe symptoms of angina and more frequent use of statins (p < 0.05).

Conclusions: SES stratified based on education level differentiates patients with stable CAD in Poland regarding their risk profile, symptom control and the use of statins. Sexual dimorphism is found mainly within SES gradients regarding the prevalence of risk factors.