Social Inequalities in Cardiovascular Risk Factors Among Older Adults in Spain: The Seniors-ENRICA Study

Rev Esp Cardiol (Engl Ed). 2017 Mar;70(3):145-154. doi: 10.1016/j.rec.2016.05.010. Epub 2016 Aug 9.
[Article in En, Spanish]


Introduction and objectives: To examine the distribution of the main cardiovascular risk factors (CVRF) according to socioeconomic level (SEL) among older adults in Spain.

Methods: A cross-sectional study conducted in 2008-2010 with 2699 individuals representative of the noninstitutionalized Spanish population aged ≥ 60 years. Socioeconomic level was assessed using educational level, occupation, and father's occupation. The CVRF included behavioral and biological factors and were measured under standardized conditions.

Results: In age- and sex-adjusted analyses, higher educational level was associated with a higher frequency of moderate alcohol consumption and leisure time physical activity, and less time spent watching television. An inverse educational gradient was observed for frequency of obesity (odds ratio [OR] in university vs primary level or below education, 0.44; 95% confidence interval [95%CI], 0.33-0.57; P-trend < .01), metabolic syndrome (OR = 0.56; 95%CI, 0.43-0.71; P-trend < .01), diabetes (OR = 0.68; 95%CI, 0.49-0.95; P-trend < .05), and cardiovascular disease (OR = 0.52; 95%CI, 0.29-0.91; P-trend < .05). Compared with a nonmanual occupation, having a manual occupation was associated with a higher frequency of several CVRF; this association was stronger than that observed for father's occupation. Differences in CVRF across SELs were generally greater in women than in men.

Conclusions: There are significant social inequalities in CVRF among older adults in Spain. Reducing these inequalities, bringing the levels of CVRF in those from lower SEL in line with the levels seen in higher SEL, could substantially reduce the prevalence of CVRF in the older adult population.

Keywords: Adulto mayor; Cardiovascular risk factor; Desigualdad social; Educación; Education; Factor de riesgo cardiovascular; Older adult; Social inequality.

MeSH terms

  • Aged
  • Alcohol Drinking / epidemiology
  • Body Mass Index
  • Cardiovascular Diseases / epidemiology*
  • Employment / statistics & numerical data
  • Exercise / physiology
  • Female
  • Health Status Disparities
  • Humans
  • Hypercholesterolemia / epidemiology
  • Hypertension / epidemiology
  • Male
  • Middle Aged
  • Risk Factors
  • Sex Distribution
  • Smoking / epidemiology
  • Socioeconomic Factors
  • Spain / epidemiology