Social gradients in cardiovascular risk factors and symptoms of Swedish men and women: The Goteborg MONICA study 1995

Background Even though coronary mortality in middle and old age is decreasi ng, social gradients may be increasing; but they need not necessarily be th e same for men and women. In order to develop efficient preventive strategi es more knowledge of the current distributions of risk factors both for men and for women is needed. Objective To investigate and to compare the socio-economic gradients for co ronary risk factors of men and women. Design A cross-sectional study. Methods We studied 686 men and 825 women aged 25-64 years from a random pop ulation sample. Socio-economic status ISES) was classified according to the occupation-based Swedish Socio-economic Index. Results For women, high SES was associated with lower levels of total and l ow-density lipoprotein cholesterol, lower serum levels of triglycerides, hi gher levels of high-density lipoprotein cholesterol and lower blood pressur e. For men, no relation between occupational status and levels of lipids an d blood pressure was found. Obesity was associated with low SES both for me n and for women. Socioeconomic differences in smoking habits were more pron ounced for women than they were for men. The proportion of post-menopausal women was higher among the unskilled workers, despite there being no differ ence in age. Optimal risk factor status (non-smoker, total cholesterol leve l < 5 mmol/l, blood pressure < 140/90 mmHg without treatment and body mass index < 25 kg/m(2)) was unusual both among men and among women, but 34% of the higher officials among the women had optimal risk factor status, compar ed with 10% of the unskilled workers. Corresponding values for the men were 16 and 9% (P for interaction 0.09). The relation between low SES and level of low-density lipoprotein cholesterol was independent of smoking, post-me nopausal state, use of oestrogen and waist:hip ratio (P = 0.04) and so was the relation between systolic blood pressure and low SES (P = 0.0003). Conclusions In Sweden, low SES exerts a stronger adverse influence on cardi ovascular risk factors of women than it does on those of men. (C) Lippincot t Williams & Wilkins.