Sex Differences in the Relationship of Socioeconomic Position With Cardiovascular Disease, Cardiovascular Risk Factors, and Estimated Cardiovascular Disease Risk: Results of the German National Cohort
Background Using data from the largest German cohort study, we aimed to investigate sex differences in the relationship of socioeconomic position (SEP) with cardiovascular disease (CVD), CVD risk factors, and estimated CVD risk. Methods and Results A total of 204 780 (50.5% women) participants from...
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2025-03-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.038708 |
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| author | Ilais Moreno Velásquez Sanne A. E. Peters Nico Dragano Karin Halina Greiser Marcus Dörr Beate Fischer Klaus Berger Anke Hannemann Renate B. Schnabel Matthias Nauck Susanne Göttlicher Susanne Rospleszcz Stefan N. Willich Lilian Krist Matthias B. Schulze Kathrin Günther Tilman Brand Tamara Schikowski Carina Emmel Börge Schmidt Karin B. Michels Rafael Mikolajczyk Alexander Kluttig Volker Harth Nadia Obi Stefanie Castell Carolina J. Klett‐Tammen Wolfgang Lieb Heiko Becher Volker Winkler Heike Minnerup André Karch Claudia Meinke‐Franze Michael Leitzmann Michael J. Stein Barbara Bohn Ben Schöttker Kira Trares Annette Peters Tobias Pischon |
| author_facet | Ilais Moreno Velásquez Sanne A. E. Peters Nico Dragano Karin Halina Greiser Marcus Dörr Beate Fischer Klaus Berger Anke Hannemann Renate B. Schnabel Matthias Nauck Susanne Göttlicher Susanne Rospleszcz Stefan N. Willich Lilian Krist Matthias B. Schulze Kathrin Günther Tilman Brand Tamara Schikowski Carina Emmel Börge Schmidt Karin B. Michels Rafael Mikolajczyk Alexander Kluttig Volker Harth Nadia Obi Stefanie Castell Carolina J. Klett‐Tammen Wolfgang Lieb Heiko Becher Volker Winkler Heike Minnerup André Karch Claudia Meinke‐Franze Michael Leitzmann Michael J. Stein Barbara Bohn Ben Schöttker Kira Trares Annette Peters Tobias Pischon |
| author_sort | Ilais Moreno Velásquez |
| collection | DOAJ |
| description | Background Using data from the largest German cohort study, we aimed to investigate sex differences in the relationship of socioeconomic position (SEP) with cardiovascular disease (CVD), CVD risk factors, and estimated CVD risk. Methods and Results A total of 204 780 (50.5% women) participants from the baseline examination of the population‐based NAKO (German National Cohort) were included. Logistic, multinomial, and linear regression models were used to estimate sex‐specific odds ratios (ORs) and β coefficients with 95% CIs of CVD, CVD risk factors, and very high‐risk score (Systemic Coronary Risk Estimation‐2) for CVD associated with SEP. Women‐to‐men ratios of ORs (RORs) with 95% CIs were estimated. In women compared with men, low versus high SEP (educational attainment and relative income) was more strongly associated with myocardial infarction, hypertension, obesity, overweight, elevated blood pressure, antihypertensive medication, and current alcohol consumption, but less strongly with current and former smoking. In women with the lowest versus highest educational level, the OR for a very high 10‐year CVD risk was 3.61 (95% CI, 2.88–4.53) compared with 1.72 (95% CI, 1.51–1.96) in men. The women‐to‐men ROR was 2.33 (95% CI, 1.78–3.05). For the comparison of low versus high relative income, the odds of having a very high 10‐year CVD risk was 2.55 (95% CI, 2.04–3.18) in women and 2.25 (95% CI, 2.08–2.42) in men (women‐to‐men ROR, 1.31 [95% CI, 1.05–1.63]). Conclusions In women and men, there was an inverse relationship between indicators of SEP and the likelihood of having several CVD risk factors and a very high 10‐year CVD risk. This association was stronger in women, suggesting that CVD risk is more strongly influenced by SEP in women compared with men. |
| format | Article |
| id | doaj-art-4203b8dda9454afe80bcd928771b675a |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-03-01 |
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| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-4203b8dda9454afe80bcd928771b675a2025-08-20T02:12:06ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-03-0114510.1161/JAHA.124.038708Sex Differences in the Relationship of Socioeconomic Position With Cardiovascular Disease, Cardiovascular Risk Factors, and Estimated Cardiovascular Disease Risk: Results of the German National CohortIlais Moreno Velásquez0Sanne A. E. Peters1Nico Dragano2Karin Halina Greiser3Marcus Dörr4Beate Fischer5Klaus Berger6Anke Hannemann7Renate B. Schnabel8Matthias Nauck9Susanne Göttlicher10Susanne Rospleszcz11Stefan N. Willich12Lilian Krist13Matthias B. Schulze14Kathrin Günther15Tilman Brand16Tamara Schikowski17Carina Emmel18Börge Schmidt19Karin B. Michels20Rafael Mikolajczyk21Alexander Kluttig22Volker Harth23Nadia Obi24Stefanie Castell25Carolina J. Klett‐Tammen26Wolfgang Lieb27Heiko Becher28Volker Winkler29Heike Minnerup30André Karch31Claudia Meinke‐Franze32Michael Leitzmann33Michael J. Stein34Barbara Bohn35Ben Schöttker36Kira Trares37Annette Peters38Tobias Pischon39Max‐Delbrück‐Center for Molecular Medicine in the Helmholtz Association (MDC) Molecular Epidemiology Research Group Berlin GermanyThe George Institute for Global Health, School of Public Health Imperial College London UKInstitute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital Heinrich Heine University Düsseldorf GermanyGerman Cancer Research Center in the Helmholtz Association DKFZ Heidelberg GermanyDepartment of Internal Medicine University Medicine Greifswald GermanyDepartment of Epidemiology and Preventive Medicine University of Regensburg GermanyInstitute of Epidemiology and Social Medicine University of Münster GermanyGerman Center of Cardiovascular Research (DZHK) Partner Site Greifswald GermanyDepartment of Cardiology, University Heart & Vascular Center Hamburg University Medical Center Hamburg‐Eppendorf Hamburg GermanyGerman Center of Cardiovascular Research (DZHK) Partner Site Greifswald GermanyInstitute of Epidemiology, Helmholtz Zentrum München ‐ German Research Center for Environmental Health Neuherberg GermanyInstitute of Epidemiology, Helmholtz Zentrum München ‐ German Research Center for Environmental Health Neuherberg GermanyInstitute of Social Medicine, Epidemiology and Health Economics Charité ‐ Universitätsmedizin Berlin GermanyInstitute of Social Medicine, Epidemiology and Health Economics Charité ‐ Universitätsmedizin Berlin GermanyDepartment of Molecular Epidemiology German Institute of Human Nutrition Potsdam Rehbruecke Nuthetal GermanyLeibniz Institute for Prevention Research and Epidemiology‐BIPS Bremen GermanyLeibniz Institute for Prevention Research and Epidemiology‐BIPS Bremen GermanyDepartment of Epidemiology IUF‐Leibniz Research Institute for Environmental Medicine Düsseldorf GermanyInstitute for Medical Informatics, Biometry and Epidemiology Essen University Hospital Essen GermanyInstitute for Medical Informatics, Biometry and Epidemiology Essen University Hospital Essen GermanyInstitute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center University of Freiburg GermanyInstitute for Medical Epidemiology, Biometrics, and Informatics, Interdisciplinary Center for Health Sciences Medical Faculty of the Martin‐Luther University Halle‐Wittenberg Halle GermanyInstitute for Medical Epidemiology, Biometrics, and Informatics, Interdisciplinary Center for Health Sciences Medical Faculty of the Martin‐Luther University Halle‐Wittenberg Halle GermanyInstitute for Occupational and Maritime Medicine Hamburg (ZfAM) University Medical Centre Hamburg‐Eppendorf (UKE) Hamburg GermanyInstitute for Occupational and Maritime Medicine Hamburg (ZfAM) University Medical Centre Hamburg‐Eppendorf (UKE) Hamburg GermanyDepartment for Epidemiology Helmholtz Centre for Infection Research Braunschweig GermanyDepartment for Epidemiology Helmholtz Centre for Infection Research Braunschweig GermanyInstitute of Epidemiology University of Kiel GermanyInstitute of Global Health University Hospital Heidelberg GermanyInstitute of Global Health University Hospital Heidelberg GermanyInstitute of Epidemiology and Social Medicine University of Münster GermanyInstitute of Epidemiology and Social Medicine University of Münster GermanyInstitute for Community Medicine University Medicine Greifswald GermanyDepartment of Epidemiology and Preventive Medicine University of Regensburg GermanyDepartment of Epidemiology and Preventive Medicine University of Regensburg GermanyNAKO e.V. Heidelberg GermanyDivision of Clinical Epidemiology and Aging Research German Cancer Research Center Heidelberg GermanyDivision of Clinical Epidemiology and Aging Research German Cancer Research Center Heidelberg GermanyInstitute of Epidemiology, Helmholtz Zentrum München ‐ German Research Center for Environmental Health Neuherberg GermanyMax‐Delbrück‐Center for Molecular Medicine in the Helmholtz Association (MDC) Molecular Epidemiology Research Group Berlin GermanyBackground Using data from the largest German cohort study, we aimed to investigate sex differences in the relationship of socioeconomic position (SEP) with cardiovascular disease (CVD), CVD risk factors, and estimated CVD risk. Methods and Results A total of 204 780 (50.5% women) participants from the baseline examination of the population‐based NAKO (German National Cohort) were included. Logistic, multinomial, and linear regression models were used to estimate sex‐specific odds ratios (ORs) and β coefficients with 95% CIs of CVD, CVD risk factors, and very high‐risk score (Systemic Coronary Risk Estimation‐2) for CVD associated with SEP. Women‐to‐men ratios of ORs (RORs) with 95% CIs were estimated. In women compared with men, low versus high SEP (educational attainment and relative income) was more strongly associated with myocardial infarction, hypertension, obesity, overweight, elevated blood pressure, antihypertensive medication, and current alcohol consumption, but less strongly with current and former smoking. In women with the lowest versus highest educational level, the OR for a very high 10‐year CVD risk was 3.61 (95% CI, 2.88–4.53) compared with 1.72 (95% CI, 1.51–1.96) in men. The women‐to‐men ROR was 2.33 (95% CI, 1.78–3.05). For the comparison of low versus high relative income, the odds of having a very high 10‐year CVD risk was 2.55 (95% CI, 2.04–3.18) in women and 2.25 (95% CI, 2.08–2.42) in men (women‐to‐men ROR, 1.31 [95% CI, 1.05–1.63]). Conclusions In women and men, there was an inverse relationship between indicators of SEP and the likelihood of having several CVD risk factors and a very high 10‐year CVD risk. This association was stronger in women, suggesting that CVD risk is more strongly influenced by SEP in women compared with men.https://www.ahajournals.org/doi/10.1161/JAHA.124.038708cardiovascular diseasecardiovascular riskeducational attainmentincomesocioeconomic position |
| spellingShingle | Ilais Moreno Velásquez Sanne A. E. Peters Nico Dragano Karin Halina Greiser Marcus Dörr Beate Fischer Klaus Berger Anke Hannemann Renate B. Schnabel Matthias Nauck Susanne Göttlicher Susanne Rospleszcz Stefan N. Willich Lilian Krist Matthias B. Schulze Kathrin Günther Tilman Brand Tamara Schikowski Carina Emmel Börge Schmidt Karin B. Michels Rafael Mikolajczyk Alexander Kluttig Volker Harth Nadia Obi Stefanie Castell Carolina J. Klett‐Tammen Wolfgang Lieb Heiko Becher Volker Winkler Heike Minnerup André Karch Claudia Meinke‐Franze Michael Leitzmann Michael J. Stein Barbara Bohn Ben Schöttker Kira Trares Annette Peters Tobias Pischon Sex Differences in the Relationship of Socioeconomic Position With Cardiovascular Disease, Cardiovascular Risk Factors, and Estimated Cardiovascular Disease Risk: Results of the German National Cohort Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiovascular disease cardiovascular risk educational attainment income socioeconomic position |
| title | Sex Differences in the Relationship of Socioeconomic Position With Cardiovascular Disease, Cardiovascular Risk Factors, and Estimated Cardiovascular Disease Risk: Results of the German National Cohort |
| title_full | Sex Differences in the Relationship of Socioeconomic Position With Cardiovascular Disease, Cardiovascular Risk Factors, and Estimated Cardiovascular Disease Risk: Results of the German National Cohort |
| title_fullStr | Sex Differences in the Relationship of Socioeconomic Position With Cardiovascular Disease, Cardiovascular Risk Factors, and Estimated Cardiovascular Disease Risk: Results of the German National Cohort |
| title_full_unstemmed | Sex Differences in the Relationship of Socioeconomic Position With Cardiovascular Disease, Cardiovascular Risk Factors, and Estimated Cardiovascular Disease Risk: Results of the German National Cohort |
| title_short | Sex Differences in the Relationship of Socioeconomic Position With Cardiovascular Disease, Cardiovascular Risk Factors, and Estimated Cardiovascular Disease Risk: Results of the German National Cohort |
| title_sort | sex differences in the relationship of socioeconomic position with cardiovascular disease cardiovascular risk factors and estimated cardiovascular disease risk results of the german national cohort |
| topic | cardiovascular disease cardiovascular risk educational attainment income socioeconomic position |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.038708 |
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