Distribution of ideal cardiovascular health by educational levels from 1978 to 2006: a time trend study from the capital region of Denmark

Abstract

Background: The focus on improvements in ideal cardiovascular health is a relatively new approach and to our knowledge nobody has published the trend in regard to educational difference.

Design: Time trend analysis from six cross-sectional studies in 1978-2006 from the south-western part of the capital region of Denmark.

Methods: This analysis included 16,935 individuals aged 30-64 years. Ideal cardiovascular health was achieved if all of the following criteria were met: no established cardiovascular disease, no diabetes, no antihypertensive or lipid-lowering treatment, non-smoker, body mass index <25 kg/m(2), blood pressure ≤120/80 mmHg and total cholesterol ≤5 mmol/l. Results are presented adjusted for age and stratified according to sex and educational level as length of vocational training.

Results: The proportion of women with ideal cardiovascular health increased from 2% in 1978 to 13% in 2006. From 1991, an educational difference occurred, increasing to a 5-fold difference in 2006 between the highest and lowest educated women. For men, a less pronounced increase occurred from 1% in 1978 to 5% in 2006; a change which was only significant among the highest educated. An educational difference occurred from 1986 to 1999 between the highest and lowest educated men, but was no longer present in 2006.

Conclusions: The trend for women shows an increasing proportion in ideal cardiovascular health with a more unfavourable risk profile among women with a low educational level. For men, the educational difference was less pronounced probably because very few men reached an ideal cardiovascular risk profile. This stresses the importance for preventive efforts targeting low educated groups, and men in particular.

Keywords: Cardiovascular disease; educational level; ideal cardiovascular health; prevention; risk factors.