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Neighbourhood socio-economic status and all-cause mortality in adults with atrial fibrillation: A cohort study of patients treated in primary care in Sweden
Karolinska Inst, Div Family Med, Dept Neurobiol Care Sci & Soc, S-14183 Huddinge, Sweden.;Stockholm Cty Council, Acad Primary Healthcare Ctr, Huddinge, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Karolinska Inst, Div Family Med, Dept Neurobiol Care Sci & Soc, S-14183 Huddinge, Sweden..
Univ Edinburgh, Coll Med & Vet Med, Ctr Populat Hlth Sci, Edinburgh, Midlothian, Scotland..
Lund Univ, Ctr Primary Hlth Care Res, Malmo, Sweden..
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2016 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 202, p. 776-781Article in journal (Refereed) Published
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Abstract [en]

Objective: Our aim was to study the potential impact of neighbourhood socio-economic status (SES) on all-cause mortality in patients with atrial fibrillation (AF) treated in primary care. Methods: Study population included adults (n = 12,283) of 45 years and older diagnosed with AF in 75 primary care centres in Sweden. Association between neighbourhood SES and all-cause mortality was explored using Cox regression analysis, with hazard ratios (HRs) and 95% confidence intervals (95% CIs), and by Laplace regression where years to death (95% CI) of the first 10% of the participants were used as an outcome. All models were conducted in both men and women and adjusted for age, educational level, marital status, change of neighbourhood status, cardiovascular co-morbidities, anticoagulant treatment and statin treatment. High-and low neighbourhood SES were compared with middle SES as reference group. Results: After adjustments for potential confounders, higher relative risk of all-cause mortality (HR 1.49, 95% CI 1.13-1.96) was observed in men living in low SES neighbourhoods compared to those from middle SES neighbourhoods. The results were confirmed using Laplace regression; the time until the first 10% of the men in low SES neighbourhoods died was 1.45 (95% CI 0.48-2.42) years shorter than for the men in middle SES neighbourhoods. Conclusions: Increased rates of heart disease and subsequent mortality among adults in deprived neighbourhoods raise important clinical and public health concerns. These findings could serve as an aid to policy-makers when allocating resources in primary health care settings as well as to clinicians who encounter patients in deprived neighbourhoods.

Place, publisher, year, edition, pages
2016. Vol. 202, p. 776-781
Keywords [en]
Neighbourhood, Atrial fibrillation, Mortality, Gender, Follow-up, Co-morbidity, Antithrombotic drugs
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-272043DOI: 10.1016/j.ijcard.2015.09.027ISI: 000366161500188PubMedID: 26474468OAI: oai:DiVA.org:uu-272043DiVA, id: diva2:893881
Funder
Swedish Research Council, K2009-70X-15428-05-3NIH (National Institute of Health), R01HL116381Available from: 2016-01-13 Created: 2016-01-11 Last updated: 2017-11-30Bibliographically approved

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