Skip Navigation



The European Journal of Public Health Advance Access published online on October 17, 2005
The European Journal of Public Health, doi:10.1093/eurpub/cki202
This Article
Right arrow Full Text (Rapid PDF)
Right arrow All Versions of this Article:
16/4/361    most recent
cki202v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Munoz, M.-A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Munoz, M.-A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2005. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Received January 27, 2005
Accepted August 29, 2005

Article

Analysis of inequalities in secondary prevention of coronary heart disease in a universal coverage health care system

Miguel-Angel Munoz 1, Izabella Rohlfs 2, Sandra Masuet 3, Carolina Rebato 2, Marta Cabañero 2, Jaume Marrugat 4*, and for the ICAR Study Group *

1 Primary care unit, Montornés-Montmeló, and Family and Community Teaching Unit, Barcelona Centre, Institut Català de la Salut, Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain
2 Lipids and Cardiovascular Epidemiology Research Unit, Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain
3 Primary care unit, Montornés-Montmeló, and Family and Community Teaching Unit, Barcelona Centre, Institut Català de la Salut, Barcelona, Spain
4 School of Medicine, Universitat Autònoma de Barcelona, Spain; Lipids and Cardiovascular Epidemiology Research Unit, Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain

* To whom correspondence should be addressed.
Jaume Marrugat, E-mail: jmarrugat{at}imim.es


  Abstract

Objective: The purpose of this study was to analyse whether differences exist in social class or education level in coronary heart disease (CHD) secondary prevention and in cardiovascular risk factor control in a universal coverage health care system. Design: Cross-sectional multi-centre study. Participants and setting: 1022 CHD patients recruited from residents in the catchment areas covered by 23 primary health care facilities in Catalonia, Spain. Main outcome measures: Demographic data, cardiovascular co-morbidity, smoking, blood pressure, fasting blood glucose, triglycerides, total cholesterol, HDL and LDL cholesterol, body mass index (BMI), drug therapy used for secondary prevention, educational level, and social class based on occupation. Results: Patients at the lowest educational level were more frequently women, older, and diabetic. Patients in the middle educational level were more frequently smokers than those in the highest or the lowest level (24.7, 8.7, and 12.0%, respectively; P = 0.008) and had better systolic blood pressure levels (125 mmHg (15), 135 mmHg (16), and 134 mmHg (17), respectively; P = 0.001). All educational levels and social classes had similar adjusted rates of risk factor control. Therapeutic management was also similar among all educational levels and social classes, after adjusting for confounders. Conclusions: CHD patients in the lower SES received similar treatment for secondary prevention and achieved similar control of risk factors. No social inequalities were found in secondary prevention in CHD patients using the National Health System in Spain.

Keywords: cardiovascular disease; health inequalities; secondary prevention; universal coverage health care system.
* See the full roster of ICAR investigators on the following website: www.regicor.org/ICAR_inv
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 HeartHome page
S DeWilde, I M Carey, N Richards, P H Whincup, and D G Cook
Trends in secondary prevention of ischaemic heart disease in the UK 1994 2005: use of individual and combination treatment
Heart, January 1, 2008; 94(1): 83 - 88.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.