Clinical InvestigationOutcomes, Health Policy, and Managed CareThe association between socioeconomic status of high-risk patients with coronary heart disease and the treatment rates of evidence-based medicine for coronary heart disease secondary prevention in China: Results from the Bridging the Gap on CHD Secondary Prevention in China (BRIG) Project
Section snippets
Study population
The study subjects of the BRIG project were selected from patients in both secondary and tertiary hospitals in all 31 provinces, autonomous regions, and municipalities of mainland China. Multistage nonrandomized sampling was used in this study. First, 57 cities or regions were selected based on their economic levels. Then, 32 secondary hospitals and 32 tertiary hospitals in the 57 cities or regions were recruited. Fifty consecutive outpatients with a history of acute coronary syndrome (ACS)
Characteristics of the study patients
A total of 2,278 CHD outpatients with complete SES information were analyzed. The characteristics of the study patients are presented in Table I. All of the patients had history of ACS, more than one third of the patients (34.3%) had history of recurrent ACS, and 10.4% had history of stroke. One third of male patients (33%) and 21% of female patients had history of PCI or CABG. Compared with male CHD patients, female CHD patients had significantly lower SES levels for all SES indicators.
The association between SES indicators and medication treatment rates
The
Discussion
This study aimed to identify the impact of SES on the treatment rates or treatment status of several key evidence-based medications for CHD secondary prevention based on a nationally representative sample of high-risk CHD outpatients in the World Heart Federation BRIG project in China.
The study provides evidence for a negative impact of low SES on medical care of high-risk CHD patients. The key findings include (1) a large disparity across SES gradients in the treatment rates of aspirin,
References (22)
- et al.
The influence of socioeconomic factors on cardiovascular disease risk factors in the context of economic development in the Samoan archipelago
Soc Sci Med
(2006) - et al.
Associations of socio-economic position and disability among older women in Britain and Jyväskylä, Finland
Arch Gerontol Geriatr
(2006) - et al.
The changing trend of serum total cholesterol in Beijing population aged 25-64 years during 1984-1999
Chin J Intern Med
(2006) - et al.
The trends of body mass index and overweight in population aged 25-64 in Beijing during 1984-1999
Chin J Epidemiol
(2003) - et al.
A cohort study on trends of cardiovascular disease risk factors in Beijing during 1992-2002
Chin J Cardiol
(2005) Cardiovascular diseases in China
Biochem Cell Biol
(2007)- et al.
- et al.
Explaining the increase in coronary heart disease mortality in Beijing between 1984 and 1999
Circulation
(2004) - et al.
Epidemiological transition of stroke in China: twenty-one-year observational study from the Sino-MONICA-Beijing Project
Stroke
(2008) - et al.
Predicting coronary heart disease deaths in Beijing in 2010: potential effects of risk factor trends
Eur J Epidemiol
(2006)
Cited by (50)
Socioeconomic deprivation and prognostic outcomes in acute coronary syndrome: A meta-analysis using multidimensional socioeconomic status indices
2023, International Journal of CardiologyRevisiting secondary prevention in coronary heart disease
2022, Indian Heart JournalSocioeconomic inequity in incidence, outcomes and care for acute coronary syndrome: A systematic review
2022, International Journal of CardiologyAssociations Between Education Level and In-hospital Treatment and Outcomes Among Acute Coronary Syndrome in China
2021, American Journal of the Medical SciencesInequalities in the use of secondary prevention of cardiovascular disease by socioeconomic status: evidence from the PURE observational study
2018, The Lancet Global HealthCitation Excerpt :Only two studies looked beyond high-income countries, both set in China. One, which developed a composite measure of socioeconomic status based on education, income, occupation, and access to medical insurance, reported 43% lower use of aspirin and over 70% lower use of antiplatelet agents, statins, and β-blockers among patients with lower socioeconomic status.11 The other study examined inequalities by age, comparing patients older and younger than 65 years, finding lower use of secondary prevention in the former.12
For members of the BRIG Project see the Appendix, (available online).