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Original Research

The Relationship Between Socioeconomic Status and CV Risk Factors: The CRONICAS Cohort Study of Peruvian Adults

Authors:

Renato Quispe,

CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, PE
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Catherine P. Benziger,

CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, PE; Division of Cardiology, University of Washington, Seattle, WA, US
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Juan Carlos Bazo-Alvarez,

CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, PE
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Laura D. Howe,

MRC Integrative Epidemiology Unit at the University of Bristol, School of Social and Community Medicine, University of Bristol, Bristol, GB
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William Checkley,

Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Pulmonary and Critical Care, School of Medicine Johns Hopkins University, Baltimore, MD, US
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Robert H. Gilman,

Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, US; Asociación Benéfica PRISMA, Lima, PE
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Liam Smeeth,

Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, GB
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Antonio Bernabé-Ortiz,

CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, PE
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J. Jaime Miranda ,

CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, PE
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Antonio Bernabé-Ortiz,

About Antonio
CRONICAS Cohort Study Group
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Juan P. Casas,

About Juan P.
CRONICAS Cohort Study Group
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George Davey Smith,

About George Davey
CRONICAS Cohort Study Group
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Shah Ebrahim,

About Shah
CRONICAS Cohort Study Group
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Héctor H. García,

About Héctor H.
CRONICAS Cohort Study Group
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Robert H. Gilman,

About Robert H.
CRONICAS Cohort Study Group
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Luis Huicho,

About Luis
CRONICAS Cohort Study Group
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Germán Málaga,

About Germán
CRONICAS Cohort Study Group
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J. Jaime Miranda,

About J. Jaime
CRONICAS Cohort Study Group
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Víctor M. Montori,

About Víctor M.
CRONICAS Cohort Study Group
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Liam Smeeth,

About Liam
CRONICAS Cohort Study Group
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William Checkley,

About William
CRONICAS Cohort Study Group
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Gregory B. Diette,

About Gregory B.
CRONICAS Cohort Study Group
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Robert H. Gilman,

About Robert H.
CRONICAS Cohort Study Group
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Luis Huicho,

About Luis
CRONICAS Cohort Study Group
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Fabiola León-Velarde,

About Fabiola
CRONICAS Cohort Study Group
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María Rivera,

About María
CRONICAS Cohort Study Group
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Robert A. Wise,

About Robert A.
CRONICAS Cohort Study Group
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William Checkley,

About William
CRONICAS Cohort Study Group
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Héctor H. García,

About Héctor H.
CRONICAS Cohort Study Group
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Robert H. Gilman,

About Robert H.
CRONICAS Cohort Study Group
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J. Jaime Miranda,

About J. Jaime
CRONICAS Cohort Study Group
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Katherine Sacksteder

About Katherine
CRONICAS Cohort Study Group
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Abstract

Background: Variations in the distribution of cardiovascular disease and risk factors by socioeconomic status (SES) have been described in affluent societies, yet a better understanding of these patterns is needed for most low- and middle-income countries.

Objective: This study sought to describe the relationship between cardiovascular risk factors and SES using monthly family income, educational attainment, and assets index, in 4 Peruvian sites.

Methods: Baseline data from an age- and sex-stratified random sample of participants, ages ≥35 years, from 4 Peruvian sites (CRONICAS Cohort Study, 2010) were used. The SES indicators considered were monthly family income (n = 3,220), educational attainment (n = 3,598), and assets index (n = 3,601). Behavioral risk factors included current tobacco use, alcohol drinking, physical activity, daily intake of fruits and vegetables, and no control of salt intake. Cardiometabolic risk factors included obesity, elevated waist circumference, hypertension, insulin resistance, diabetes mellitus, low high-density lipoprotein cholesterol, and high triglyceride levels.

Results: In the overall population, 41.6% reported a monthly family income <US$198, and 45.6% had none or primary education. Important differences were noted between the socioeconomic indicators: for example, higher income and higher scores on an asset index were associated with greater risk of obesity, whereas higher levels of education were associated with lower risk of obesity. In contrast, higher SES according to all 3 indicators was associated with higher levels of triglycerides.

Conclusions: The association between SES and cardiometabolic risk factors varies depending on the SES indicator used. These results highlight the need to contextualize risk factors by socioeconomic groups in Latin American settings.

Highlights

  • The relationship between socioeconomic status (SES) and risk factors for cardiovascular disease depends on the indicator used.
  • High SES groups, based on income level, had a higher prevalence of elevated waist circumference (WC) and obesity than did the low-income group.
  • High SES groups, based on educational attainment, had higher prevalence of elevated triglycerides but lower prevalence of obesity than did low-education groups.
  • High SES groups, based on assets index, had higher prevalence of elevated WC, elevated triglycerides, and insulin resistance.
How to Cite: Quispe R, Benziger CP, Bazo-Alvarez JC, Howe LD, Checkley W, Gilman RH, et al.. The Relationship Between Socioeconomic Status and CV Risk Factors: The CRONICAS Cohort Study of Peruvian Adults. Global Heart. 2016;11(1):121–30. DOI: http://doi.org/10.1016/j.gheart.2015.12.005
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Published on 01 Mar 2016.
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