Background: Cardiovascular disease (CVD) events are highly preventable and disproportionately affect socioeconomically disadvantaged individuals, challenging efforts to reduce CVD burden. Population-level data on variations in absolute CVD risk and treatment are needed.
Aim: To estimate absolute and relative socioeconomic inequalities in absolute CVD risk and use of guideline-recommended medications in the Australian population to identify opportunities to reduce inequalities in CVD events.
Methods: Cross-sectional representative data on 4,751 people aged 45-74 from the 2011-12 Australian National Health Survey, including interview, physical measurement, and blood and urine sample data. Poisson regression with robust standard errors was used to calculate prevalence differences (PD) and ratios (PR) for prior CVD, high 5-year absolute risk of a primary CVD event and guideline-recommended medication use, in relation to socioeconomic position (SEP, measured by education).
Results: Age- and sex-adjusted prevalence of high absolute risk of a primary CVD event among those of low (school certificate), intermediate (certificate/diploma/trade) and high (university degree) SEP were 12.6%, 10.9% and 7.7%, respectively (PD, low vs. high SEP=5.0% [95%CI:2.3-7.7], PR=1.6 [1.2-2.2]); corresponding prevalences for prior CVD were 10.7%, 9.1% and 6.7% (PD=4.0% [1.4-6.6], PR=1.6 [1.1-2.2]). Proportions using recommended preventive medication among those with high primary risk were 21.3%, 19.5% and 29.4% for low, intermediate and high SEP (PD=-8.1 [-24.9-8.8], PR=0.7 [0.4-1.3]), respectively; corresponding results for prior CVD were 37.8%, 35.7% and 17.7% (PD=20.2 [9.7-30.5], PR=2.1 [1.3-3.5]).
Conclusion: There is substantial potential to prevent CVD events and reduce inequalities through appropriate management of high absolute CVD risk in the population.