How the risk of congenital heart disease and cardiovascular disease in adults are much higher among women than men with lower socioeconomic status.

“To date, there has been no systematic synthesis of the literature comparing sex differences in the relationship between markers of [socioeconomic status] and CVD,” Kathryn Backholer, PhD, of the School of Health and Social Development at Deakin University in Victoria, Australia, and colleagues wrote. “We, therefore, conducted a systematic review and meta-analysis to ascertain the most reliable estimate of the sex differences in the [RRs] of socioeconomic status on the risk of incident CHD, stroke and CVD in the general population.”

The researchers analyzed 116 cohorts, including 22 million individuals (35% women), from Asia (n = 22), Europe (n = 75), North America (n = 7) and Australasia (n = 12). More than 1 million CVD events were documented.

Across the studies, socioeconomic status was determined by educational attainment, area-level deprivation, occupation or income.

Sex differences
For CHD, when the lowest level of education was compared with the highest, the pooled age-adjusted RR for women was 1.66 (95% CI, 1.46-1.88) vs. 1.3 (95% CI, 1.15-1.48) for men. The pooled RRs remained significantly different for women vs. men when adjusting for CVD risk factors.

Women with the lowest level of education were a higher risk for CHD compared with men with the same level of education (age-adjusted RR = 1.24; 95% CI, 1.09-1.41). The risk remained significant after adjustments for CVD risk factors (RR = 1.34; 95% CI, 1.09-1.63).

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