Relationship between socioeconomic factors and coronary artery disease among under-45 year-old individuals in Shahid Rajaee Hospital, Tehran, Iran: A case-control study

Previous studies show that disability and mortality due to cardiovascular diseases are closely related to socioeconomic status in a community. The objective of this study was to determine the relationships between socioeconomic factors and coronary artery disease (CAD) among people under 45 years old at Shahid Rajaei Hospital, Tehran, Iran. This case-control study was conducted in Shahid Rajaei Hospital, Tehran, Iran in summer 2008. The participants were 100 CAD cases (<45 years old, mean age = 41.2 years; 85% men) and 100 controls from among accompanying persons matched for age and gender. In order to assess the risk of factors related to such variables as educational level, occupation, income, social exclusion, social support, stress, exercise, nutritional status, smoking, etc, odds ratio (95% CI) was used. Multinomial logistic regression was used to assess the synchronic effect of the risk factors, and the t-test was used to find differences between means. The odds ratio (95% CI) for smoking vs nonsmoking was 3.9 (1.9-7.9) for CAD. Individuals with a low educational level showed an odds ratio of 2.7 (1.9-7-9), compared to those with a high educational level. Eating fruits and vegetables at least seven servings a week has an odds ratio of 2.7 (1.01-7.4) vs eating fewer servings. Occupation, job grade and physical activity had statistically significant relationships with CAD. Mean BMI was different between cases and controls. The disease had no significant association with stress, social support, social exclusion or income. Smoking, a low educational level and eating small amounts of fruits and vegetables were the most important socioeconomic factors contributing to coronary artery disease. Policymaking and planning aiming at improving the socioeconomic situation of the people, particularly those under 45 years old, seem essential