SOCIOECONOMIC-STATUS AND RISK-FACTORS FOR CARDIOVASCULAR-DISEASE - A MULTICENTER COLLABORATIVE STUDY IN THE INTERNATIONAL CLINICAL EPIDEMIOLOGY NETWORK (INCLEN)

As part of a multicentre collaborative study of risk factors for cardi ovascular disease (CVD) in the International Clinical Epidemiology Net work (INCLEN), each of 12 Centres in 7 countries examined the relation ship between CVD risk factors and socio-economic variables. Each Centr e (three in Thailand, two each in China, Chile and Brazil and one each in the Philippines, Indonesia and Colombia) examined approx. 200 men aged 35-65 drawn at random from a population within their locality (no t designed to be necessarily representative of the general population) . Standardized measures of CVD risk factors included body mass index ( BMI), blood pressure, blood cholesterol and cigarette smoking habits. Education, occupation and current income were grouped into ordinal cat egories of socio-economic status according to standard protocol guidel ines, and comparisons were made between risk factor levels within each of these categories. Many of these populations had higher levels of e ducation (as a marker of socio-economic status) than would the general population of their country. For both BMI and blood cholesterol there were a number of centres which showed positive associations with soci o-economic status. These were predominately in China or urban or rural South East Asia. For Mood pressure and cigarette smoking the associat ions with socio-economic status tended to be negative, more in line wi th the direction of association seen in the ''Developed'' World. The h igh risk factor levels found in these populations, particularly the al arming prevalence of cigarette smoking in Asia and the high cholestero l levels in Latin America and Urban S.E. Asia suggest that CVD will em erge as a major public health problem in the Developing World. As this happens, knowledge of the patterns of association between risk and so cio-economic status is likely to be important in both understanding th e reasons for the patterns of disease and directing efforts at prevent ion.