Isfahan University of Medical Sciences, Isfahan, Iran
Background and Objective- Atherosclerotic coronary artery disease is an important cause of mortality worldwide. Huge economic burdens, various health complications and high mortality due to atherosclerotic coronary artery disease necessitate the identification and control of its risk factors. In addition to serving as the underlying cause of many coronary- artery-disease risk factors, low socioeconomic status seems to act as an independent risk factor during childhood and adolescence for the development of cardiovascular diseases later in life. The objective of this study is to assess the influence of socioeconomic status during childhood, alongside other known risk factors, on the development of cardiovascular diseases.
Patients and Methods- This is a prospective, case-control study of 600 patients in private and state-run university hospitals with coronary care units. The patients were matched for sex, age and characteristics other than those under study. We assessed the influence of socioeconomic status in childhood, alongside other known risk factors, on the development of coronary artery disease.
Results- Men constituted 69.1% and 65.2% of the case and control groups respectively. The two groups were similar in terms of the patients’ mean age. Most of the women were housewives, and men were typically occupied in jobs involving little physical activity. 47.5% and 45.5% of the patients in the case group belonged to the lower and middle-income brackets, respectively. 35.6% and 58.16% of the patients in the control group belonged to the lower and middle-income brackets respectively, showing a statistically significant difference from the case group. Positive family history of cardiovascular disease, cigarette smoking, hypertension, diabetes, obesity and hyperlipidemia were other risk factors of coronary artery disease in the case group as suggested by this study, with a statistically significant difference from the control group.
Conclusion- The income difference between the case and control groups was significant in terms of developing coronary artery disease. Similar studies have also pointed to a higher chance of developing atherosclerotic coronary artery disease in individuals belonging to the lower-income brackets during their childhood. Our findings regarding the influence of cigarette smoking, positive family history of cardiovascular disease, diabetes, hypertension, hyperlipidemia and obesity on the development of coronary artery disease are consistent with the results of similar studies in other parts of the world. These findings call for new measures to be taken by community health authorities and policy makers to curb the ever-increasing incidence of cardiovascular diseases in the society