Deprivation and trends in blood pressure, cholesterol, body mass index and smoking among participants of a UK primary care-based cardiovascular risk factor screening programme: both narrowing and widening in cardiovascular risk factor inequalities
- 1Norfolk, Suffolk and Cambridgeshire Strategic Health Authority, Cambridge, UK
- 2Evidence for Population Health Unit, University of Manchester, Manchester, UK
- 3Hunter New England Population Health, New Lambton, New South Wales, Australia
- 4Former Stockport Healthcare NHS Trust, Stockport, UK
- 5Stockport NHS Trust, Stockport, UK
- Correspondence to:
Dr Georgios Lyratzopoulos
Norfolk, Suffolk and Cambridgeshire Strategic Health Authority, Victoria House, Capital Park, Fulbourn, Cambridge CB1 5XB, UK; georgios.lyratzopoulos{at}nscsha.nhs.uk
- Accepted 2 February 2006
Abstract
Objectives: To examine recent time trends in blood pressure (BP), total cholesterol, body mass index (BMI) and current smoking among people in the UK of different deprivation groups.
Design: Repeatable survey.
Setting: Primary care-based UK cardiovascular risk factor screening programme (58 Stockport general practices).
Participants: 37 161 women and 33 977 men aged 35–60 years responding to a screening invitation and with a first screening episode during 1989–99.
Results: There were significant decreasing trends in total cholesterol (−0.06 mmol/l/year, 95% confidence interval (CI) −0.07 to −0.06 for women, −0.07 mmol/l/year, 95% CI −0.07 to −0.06 for men), with a significantly faster drop in more deprived groups (−0.005 mmol/year/increasing deprivation group, 95% CI −0.01 to −0.001 for both sexes). There were decreasing trends in current smoking prevalence (odds ratio (OR) 0.97/year, 95% CI 0.96 to 0.97 for women, OR 0.96/year, 95% CI 0.95 to 0.96 for men) with a significantly slower drop in the more deprived groups (OR 1.01/year/increasing deprivation group, 95% CI 1.00 to 1.01 for both sexes). There were significant increasing trends in BMI (0.11 kg/m2/year in women, 95% CI 0.09 to 0.13, 0.10 kg/m2/year in men, 95% CI 0.08 to 0.11), with a significantly slower increase in the more deprived groups among men only (−0.02 kg/m2/year/increasing deprivation group, 95% CI −0.01 to −0.03). Inequality in BP narrowed among men but widened among women.
Conclusion: Inequalities in risk factors between different deprivation groups may be both widening (smoking, BP in women) and narrowing (total cholesterol, BMI and BP in men). Given baseline inequalities in risk factors levels, these trends suggest that inequalities in cardiovascular disease are likely to persist in the future.
Footnotes
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Published Online First 8 February 2006
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Competing interests: None declared.
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Authors’ contributions: GL identified the research question, with support from RFH. GL developed the statistical methods, with supervisory support by PMcE. PL and MH have over a number of years helped run the Stockport Cardiovascular Risk Factor Screening Programme, and collect and collate data that enabled the analysis to be carried out. GL wrote the first draft of the manuscript. All authors contributed to the writing of the paper and read and approved the final manuscript. The work leading to this report has been carried out as partial fulfilment of study for the degree of MD, University of Manchester, for GL. RFH is GL’s supervisor for the named degree and P McElduff is GL’s advisor
