Mosca, Irene and Ni Bhuachalla, Blaithin and Kenny, Rose Anne (2013) Explaining significant differences in subjective and objective measures of cardiovascular health: evidence for the socioeconomic gradient in a population-based study. BMC Cardiovascular Disorders, 13 (1). p. 64. ISSN 1471-2261

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Abstract

Background: To assess prevalence rates of subjective and objective reports of two cardiovascular disorders (hypertension and hypercholesterolemia) for the same subset of respondents in a large-scale study. To determine whether and the extent to which the socioeconomic health gradient differed in the subjective and objective reports of the two cardiovascular disorders. Methods: Data from the first wave (2009/2011) of The Irish Longitudinal Study on Ageing were used (n = 4,179). This is a nationally representative study of community-dwelling adults aged 50+ residing in Ireland. Subjective measures were derived from self-reports of doctor-diagnosed hypertension and high cholesterol. Objective measure of hypertension was defined as: systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg and/or on antihypertensive medication. Objective measure of hypercholesterolemia was defined as: total cholesterol ≥5.2 mmol/L and/or on cholesterol-lowering medication. Objective measures of low-density-lipoprotein cholesterol and high-density-lipoprotein cholesterol were also used. Two measures of socioeconomic gradient were employed: education and wealth. Binary and multinomial logistic and linear regression analyses were used. Analyses were adjusted for an extensive battery of covariates, including demographics and measures of physical/behavioural health and health care utilization. Results: Prevalence of cardiovascular disorders: prevalence of hypertension and hypercholesterolemia was significantly higher when the cardiovascular disorders were measured objectively as compared to self-reports (64% and 72.1% versus 37% and 41.1%, respectively). Socioeconomic gradient in hypertension: the odds of being objectively hypertensive were significantly lower for individuals with tertiary/higher education (OR, 0.74; 95% CI, 0.60-0.92) and in the highest tertile of the wealth distribution (OR, 0.77; 95% CI, 0.62-0.95). In contrast, the associations between socioeconomic status and self-reported hypertension were not statistically significant. Socioeconomic gradient in hypercholesterolemia: wealthier individuals had higher odds of self-reporting elevated cholesterol (OR, 1.28; 95% CI, 1.03-1.58). Associations between socioeconomic status and objectively measured hypercholesterolemia and low-density-lipoprotein cholesterol were not significant. Higher education and, to a lesser extent, greater wealth were associated with higher levels of high-density-lipoprotein cholesterol. Conclusions: Clear discrepancies in prevalence rates and gradients by socioeconomic status were found between subjective and objective reports of both disorders. This emphasizes the importance of objective measures when collecting population data.

Item Type:	Article
Keywords:	Mortality; Cardiac & Cardiovascular Szstems; Self-Assessed Health; Morbidity; European Countries; Reported Health; Disease; Rated Health; Income-Related Inequalities; Hypertension; England Humans; Middle Aged; Hypercholesterolemia - economics; Ireland - epidemiology; Male; Educational Status; Self Report - economics; Socioeconomic Factors; Hypercholesterolemia - diagnosis; Aged; 80 and over; Cardiovascular Diseases - epidemiology; Female; Hypertension - epidemiology; Hypertension - diagnosis; Hypertension - economics; Longitudinal Studies; Population Surveillance - methods; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - economics; Hypercholesterolemia - epidemiology; Hypertension; Medicine; Experimental; Medical research; Hypercholesterolemia; Analysis; Anticholesteremic agents;
Academic Unit:	Faculty of Social Sciences > Economics, Finance and Accounting
Item ID:	11381
Identification Number:	https://doi.org/10.1186/1471-2261-13-64
Depositing User:	Irene Mosca
Date Deposited:	18 Oct 2019 10:20
Journal or Publication Title:	BMC Cardiovascular Disorders
Publisher:	BMC
Refereed:	Yes
URI:	Publisher
Use Licence:	This item is available under a Creative Commons Attribution Non Commercial Share Alike Licence (CC BY-NC-SA). Details of this licence are available here

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