Good news, and bad news, for Scotland in the trends and inequalities associated with cardiovacular disease risk factors
posted on: May 22, 2012
In Scotland, over a fourteen-year period between 1995 and 2009, there has been a decline in the number of people with high cholesterol. This good news in the battle against cardiovascular disease is tempered by the stark fact that the majority of adults still have elevated cholesterol levels. There are worrying trends in other cardiovascular disease risk factors with the proportion of individuals with hypertension hardly changing and the prevalence of obesity, including central obesity, increasing. The most disadvantaged within the population tended to have the highest levels of harmful risk factors and this did not change over the 14 year-period. This provides evidence for the persistence of socioeconomic inequalities. These findings may contribute to an understanding of why there has been a possible slowing in the decline, and the persistence of inequalities, in coronary heart disease mortality in Scotland.
Scottish trends in cardiovascular disease risk factors were examined as part of a study led by Dr Joel Hotchkiss at the MRC/CSO Social and Public Health Sciences Unit. It was conducted in collaboration with colleagues in the Unit and at the University of Liverpool and the Scottish Centre for Social Research. The research, published in the online journal BMJ Open, was funded by the Chief Scientist Office of the Scottish Government Health Directorate within a programme funded by both the Medical Research Council and the Chief Scientist Office. A previous study focusing on behavioural risk factors for cardiovascular disease, such as smoking, has already been published http://bmjopen.bmj.com/content/1/1/e000176.full.pdf+html. This identified that there had been at best only a moderate decline in behavioural risk factors and an increase in diabetes. As in the study reported here, socioeconomic inequalities had not reduced.
The study was based on 27,509 respondents to the 1995, 1998, 2003, 2008 and 2009 Scottish Health Surveys that were between 25 and 64 years of age. The surveys are representative of the Scottish population and anonymously record information on participants’ health, their lifestyle choices and medical measurements. The trends identified in this study, and in the previous behavioural risk factors study, can only serve to curb any further declines in coronary heart disease mortality and maintain associated inequalities. If there are to be further reductions in coronary heart disease mortality and elimination of associated inequalities then there needs to be a favourable step change in the prevalence of cardiovascular disease risk factors. This may require radical population-wide interventions.