Socioeconomic status and trends in risk factors for cardiovascular diseases in the Danish MONICA population, 1982-1992

Study objective-The decline in cardiovascular mortality in Denmark during t he 1980s has been greatest in the highest socioeconomic groups of the popul ation. This study examines whether the increased social inequalib in cardio vascular mortality has been accompanied by a different trend in cardiovascu lar risk factors in different educational groups. Design-Data from three cross sectional WHO MONICA surveys conducted in 1982 -84, 1987, and 1991-92, were analysed to estimate trends in biological (wei ght, height, body mass index, blood pressure, and serum Lipids) and behavio ural (smoking, physical activity during leisure, and eating habits) risk fa ctors in relation to educational status. Setting-Country of Copenhagen, Denmark. Participants-6695 Danish men and women of ages 30, 40, 50, and 60 years. Main results-The prevalence of smoking and heavy smoking decreased during t he study but only in the most educated groups. In fact, the prevalence of h eavy smoking increased in the least educated women. There was no significan t interaction for the remaining biological and behavioural risk factors bet ween time of examination and educational level, indicating that the trend w as the same in the different educational groups. However, a summary index b ased on seven cardiovascular risk factors improved, and this development wa s only seen in the most educated men and women. Conclusion-The difference between educational groups in prevalence of smoki ng increased during the 1980s, and this accounted for widening of an existi ng social difference in the total cardiovascular risk.