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Differences in cardiovascular mortality between Australia and New Zealand according to socioeconomic status: findings from the Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study.
- Source :
-
The New Zealand medical journal [N Z Med J] 2008 Feb 15; Vol. 121 (1269), pp. 11-23. Date of Electronic Publication: 2008 Feb 15. - Publication Year :
- 2008
-
Abstract
- Background: Cardiovascular mortality is higher in New Zealand compared to Australia, but reasons for this difference are uncertain. This study describes differences in cardiovascular risk factors and cardiovascular mortality in Australians and New Zealanders with stable coronary artery disease stratified by socioeconomic status.<br />Methods: Socioeconomic status was estimated from the residential area of 5949 Australians and 2784 New Zealanders with a history of myocardial infarction or unstable angina who participated in the Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study. Socioeconomic and international differences in cardiovascular risk factors, medical treatments, and cardiovascular mortality during a median follow-up period of 7.8 years were evaluated.<br />Results: Cardiovascular mortality increased as the median residential-area income decreased in both Australia (hazard ratio [HR]/income tertile 1.20, 95% confidence interval [CI] 1.08-1.32) and New Zealand (HR 1.16, 95%CI 1.02-1.31), but was higher in New Zealand across all socioeconomic groups (HR 1.42, 95%CI 1.25-1.61). Obesity, smoking, and a high white blood cell count at baseline were associated with higher cardiovascular mortality and were more common in lower-income areas in both countries. The total:HDL cholesterol ratio was higher in New Zealand, but similar across all socioeconomic groups. In both countries there were socioeconomic gradients in open-label usage of cholesterol-lowering medication, percutaneous coronary intervention, and coronary artery bypass surgery. However, Australians in all socioeconomic groups were more likely than New Zealanders to receive these treatments.<br />Conclusions: Although there is an important socioeconomic gradient in cardiovascular mortality in both Australia and New Zealand, cardiovascular mortality is higher in New Zealanders than Australians with stable coronary disease from all socioeconomic groups.
- Subjects :
- Adult
Aged
Australia epidemiology
Chi-Square Distribution
Female
Follow-Up Studies
Humans
Income statistics & numerical data
Linear Models
Male
Middle Aged
New Zealand epidemiology
Risk Factors
Severity of Illness Index
Cardiovascular Diseases mortality
Cardiovascular Diseases prevention & control
Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use
Pravastatin therapeutic use
Social Class
Subjects
Details
- Language :
- English
- ISSN :
- 1175-8716
- Volume :
- 121
- Issue :
- 1269
- Database :
- MEDLINE
- Journal :
- The New Zealand medical journal
- Publication Type :
- Academic Journal
- Accession number :
- 18278078