Fornari et al. BMC Public Health 2010, 10:574 http://www.biomedcentral.com/1471-2458/10/574 Page 5 of 9 Table 3 Cardiovascular risk factors in relation to social status indicators WOMEN EDUCATIONAL LEVEL MARITAL STATUS High Medium Low Married or Cohabitating Other living arrangements mean (s.d.) mean (s.d.) mean (s.d.) mean (s.d.) mean (s.d.) Systolic blood pressure (mmHg)*^ 132.3 (17.0) ° 135.5 (18.7)’ 138.2 (20.4) 136.3 (19.0) 134.3 (19.3) Diastolic blood pressure (mmHg)*^ 80.6 (9.5) ° 82.4 (10.2)’ 85.2 (11.3) 83.4 (10.7) 82.2 (10.4) Total Cholesterol (mg/dl)* 233.3 (41.5) ° 230.5 (41.3)’ 222.4 (41.2) 227.0 (41.3) 227.7 (43.0) HDL Cholesterol (mg/dl)*^ 63.5 (15.7) ° 60.8 (15.6)’ 56.7 (14.2) 59.5 (15.4) 60.4 (15.1) Triglycerides (mg/dl)*^ 106.1 (55.2) ° 110.3 (64.4)’ 121.6 (70.4) 116.1 (65.1) 110.6 (65.0) BMI (kg/m2)*^ 25.6 (4.0) ° 26.7 (4.4)’ 28.4 (4.9) 27.3 (4.7) 26.5 (4.7) Cardiovascular risk score§* 2.6 (1.9) ° 2.9 (2.2) 2.8 (2.8) 2.8 (2.2) 2.8 (3.2) n (%) n (%) n (%) n (%) n (%) Diabetes (Yes/No)* 64 (2.2) ° 100 (3.4)’ 312 (5.2) 392 (4.2) 94 (3.5) Smoke (Yes/No)*^ 1371 (34.0) ° 1096 (30.0)’ 855 (16.4) 2730 (23.9) 647 (31.7) Antihypertensive Medication (Yes/No)* 333 (11.3) ° 448 (14.8)’ 1054 (17.3) 1481 (15.4) 411 (14.2) Women 35-69 years-old, free of previous CVD. Age-adjusted means and percentages using European Population 1995. s.d.=standard deviation. *p < 0.05. ANOVA for continuous variables (test F) and Chi-squared test for categorical variables among educational levels. Bonferroni correction for multiple comparisons was used: High vs Medium; ° High vs Low; ‘ Medium vs Low. ^ p < 0.05. ANOVA for continuous variables (test F) and Chi-squared Test for categorical variables among marital status categories. § Cardiovascular risk score calculated using Progetto CUORE Study equation. events was higher in less educated men than in highly educated men (HR 1.41, IC 95% 1.10-1.81). This relation- ship was not found in the other regions. Case-fatality was higher for men living alone both in the North and in the Centre-South of Italy. No significant differences in inci- dence of cardiovascular events or case-fatality by social status were found in women when they were analyzed by geographical area. Discussion In Italy, in the past, the risk of cardiovascular events was traditionally considered higher in upper socio-economic Table 4 Hazard ratio (HR) and 95% confidence intervals (CI) for cardiovascular events by social status indicators classes MEN WOMEN Educational level High Medium Low Marital Status Married or cohabitating Other living arrangements Educational level High Medium Low Marital Status Married or cohabitating Other living arrangements n 132 184 381 627 86 38 75 235 270 92 p/y 25739 25303 39743 81590 9341 32944 35647 67106 ALL HRa (CI 95%) Ref. 1.06 (0.83;1.35) 1.08 (0.84;1.39) Ref. 1.16 (0.91;1.49) Ref. 1.30 (0.84;2.03) 1.24 (0.81;1.90) 115150 23172 Ref. 1.18 (0.91;1.52) n 115 141 147 348 58 27 58 74 130 35 NORTH HRa (CI 95%) p/y CENTRE-SOUTH p/y HRa (CI 95%) 21907 18793 12371 46915 6444 15721 23317 19065 49214 9495 Ref. 0.99 (0.76;1.29) 1.41 (1.08;1.82) Ref. 1.08 (0.80;1.47) Ref. 0.96 (0.56-1.64) 1.23 (0.72-2.11) Ref. 0.93 (0.62-1.40) n 17 43 234 279 28 11 17 161 140 57 3832 6510 26372 34674 2897 17223 12330 48041 65936 13677 Ref. 1.23 (0.68;2.19) 0.80 (0.47;1.34) Ref. 1.27 (0.85;1.88) Ref. 2.05 (0.96-4.37) 1.75 (0.89-3.45) Ref. 1.28 (0.92-1.78) Men and women 35-69 years old free of previous CVD at baseline (ALL). The population is then stratified by geographical area (NORTH vs. CENTRE-SOUTH of Italy). n=number of first cardiovascular events. p/y=person-years. Ref.= reference. a HR for educational levels adjusted for age, systolic blood pressure, total cholesterol, HDL cholesterol, diabetes (yes, no), smoking habits (yes, no), anti hypertensive medication(yes, no). HR for marital status adjusted for age, systolic blood pressure, total cholesterol, HDL cholesterol, diabetes (yes, no), smoking habits (yes, no), anti hypertensive medication (yes, no), education (three levels).