Association Between Low Education and Higher Global Cardiovascular Risk

Tiziana Di Chiara, Alessandra Scaglione, Salvatore Corrao, Christiano Argano, Antonio Pinto, Rosario Scaglione

This study was designed to evaluate the impact of educational status on global cardiovascular risk in a southern Italian urban population. The study population consisted of 488 consecutive outpatients aged 18 years and older. Educational status was categorized according to the number of years of formal education as follows: (1) low education group (<10 years) and (2) medium-high education group (10-15 years). In both groups, cardiometabolic comorbidities (obesity, visceral obesity, diabetes, dyslipidemia, metabolic syndrome, microalbuminuria, left ventricular hypertrophy) and global cardiovascular risk, according to international guidelines, were analyzed. Left ventricular mass index and ejection fraction by echocardiography and E/A ratio, by pulsed-wave Doppler, were calculated. The low education group was characterized by a significantly higher prevalence of patients with visceral obesity (P=.021), hypertension (P=.010), metabolic syndrome (P=.000), and microalbuminuria (P=.000) and greater global cardiovascular risk (P=.000). Significantly increased levels of microalbuminuria (P=.000) and significantly decreased values of E/A ratio (P=.000) were also detected in the low education group. Global cardiovascular risk correlated directly with waist-to-hip ratio (P=.010), microalbuminuria (P=.015), and the metabolic syndrome (P>.012) and inversely with educational status (P=.000). Education was independently (P=.000) associated with global cardiovascular risk. These data indicate a strong association between low education and cardiometabolic comorbidities suitable to influence the evolution of chronic degenerative diseases. Preventive strategies need to be more efficient and more effective in this patient population.