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Cardiac risk factors and prevention
Original article
Cross-sectional analysis of deprivation and ideal cardiovascular health in the Paris Prospective Study 3
  1. J P Empana1,2,
  2. M C Perier1,2,
  3. A Singh-Manoux3,4,
  4. B Gaye1,2,
  5. F Thomas5,
  6. C Prugger6,
  7. M Plichart1,2,7,
  8. E Wiernik3,4,
  9. C Guibout1,2,
  10. C Lemogne2,8,9,
  11. B Pannier5,
  12. P Boutouyrie1,2,10,
  13. X Jouven1,2,11
  1. 1Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France
  2. 2Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
  3. 3INSERM, U1018, Epidemiology of Ageing and Age Related Diseases, Villejuif, France
  4. 4Université Paris-Saclay, Univ. Paris-Sud, UVSQ, France
  5. 5Preventive and Clinical Investigation Center, Paris, France
  6. 6Institute of Public Health, Charité University Medicine Berlin, Berlin, Germany
  7. 7Department of Geriatry, APHP, Hopital Broca, Paris, France
  8. 8Psychiatry Department, APHP, Georges Pompidou European Hospital, Paris, France
  9. 9INSERM, Centre for Psychiatry and Neuroscience, Paris, France
  10. 10Pharmacology Departments, APHP, Georges Pompidou European Hospital, Paris, France
  11. 11Cardiology Department, APHP, Georges Pompidou European Hospital, Paris, France
  1. Correspondence to Dr J P Empana; INSERM U970, Paris Cardiovascular Research Center (PARCC), 56 Rue Leblanc Paris 75015, France; jean-philippe.empana{at}inserm.fr

Abstract

Aims We hypothesised that deprivation might represent a barrier to attain an ideal cardiovascular health (CVH) as defined by the American Heart Association (AHA).

Methods and results The baseline data of 8916 participants of the Paris Prospective Study 3, an observational cohort on novel markers for future cardiovascular disease, were used. The AHA 7-item tool includes four health behaviours (smoking, body weight, physical activity and optimal diet) and three biological measures (blood cholesterol, blood glucose and blood pressure). A validated 11-item score of individual material and psychosocial deprivation, the Evaluation de la Précarité et des Inégalités dans les Centres d'Examens de Santé—Evaluation of Deprivation and Inequalities in Health Examination centres (EPICES) score was used. The mean age was 59.5 years (standard deviation 6.2), 61.2% were men and 9.98% had an ideal CVH. In sex-specific multivariable polytomous logistic regression, the odds ratio (OR) for ideal behavioural CVH progressively decreased with quartile of increasing deprivation, from 0.54 (95% CI 0.41 to 0.72) to 0.49 (0.37 to 0.65) in women and from 0.61 (0.50 to 0.76) to 0.57 (0.46 to 0.71) in men. Associations with ideal biological CVH were confined to the most deprived women (OR=0.60; 95% CI 0.37 to 0.99), whereas in men, greater deprivation was related to higher OR of intermediate biological CVH (OR=1.28; 95% CI 1.05 to 1.57 for the third quartile vs the first quartile).

Conclusions Higher material and psychosocial deprivation may represent a barrier to reach an ideal CVH.

Trial registration number NCT00741728.

https://doi.org/10.1136/heartjnl-2016-309502

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    Footnotes

    • Contributors  Design of the study: JPE and XJ. Drafting the manuscript: JPE. Statistical analysis: JPE and MCP. Critical review of important intellectual content: all authors. Responsibility of the integrity of the data: JPE and XJ.

    • Funding The PPS3 was supported by grants from The National Research Agency (ANR), the Research Foundation for Hypertension (FRHTA), the Research Institute in Public Health (IRESP) and the Region Ile de France (Domaine d'Intérêt Majeur). EWwas supported by a grant from GESTES/Région Île-de-France. BGwas supported by a grant from the French Ministry of Research and Education.

    • Competing interests CL has received advisory panels or lecture fees from AstraZeneca, Bristol-Myers Squibb, Lundbeck, Pfizer, Pierre Fabre, Sanofi and Servier. AS-M receives research support from the National Institute of Health (NIH) (NIA R01AG013196 (principal investigator), National Institute of Aging (NIA) R01-AG034454 (principal investigator)) and the British Medical Research Council (MRC) (G0902037 (co-investigator)) outside the submitted work.

    • Patient consent Obtained.

    • Ethics approval WHO International Clinical Trial Registry Platform: NCT00741728. The study protocol was approved by the ethics committee of the Cochin Hospital (Paris, France).

    • Provenance and peer review Not commissioned; externally peer reviewed.