Inequalities in coronary revascularisation during the 1990s: evidence from the British regional heart study

R W Morris, P H Whincup, O Papacosta, M Walker, A Thomson

Research output: Contribution to journalArticle (Academic Journal)

33 Citations (Scopus)

Abstract

OBJECTIVE: To investigate the influence of age and social circumstances on probability of revascularisation among British men.

DESIGN: Prospective population based study

SETTING: 24 medium sized British towns, none of which contained a hospital undertaking coronary artery bypass surgery.

SUBJECTS: 5814 surviving participants of the BRHS (British regional heart study), aged 52-73 years, with no history of revascularisation when responding to a questionnaire in November 1992.

MAIN OUTCOMES: Incident coronary revascularisations, as documented in general practitioner records, over the following 7.1 years and coronary angiography investigations reported by men in a further questionnaire in November 1996.

RESULTS: 160 men underwent at least one revascularisation during this period (4.2/1000 person-years). In multifactorial analysis, which included adjustment for incidence of major coronary heart disease or angina, a lower incidence of revascularisation was found among men aged over 65 years in November 1992 (hazard ratio 0.62, 95% confidence interval (CI) 0.44 to 0.87), among men with manual occupations (0.73, 95% CI 0.53 to 1.02), among men living in households possessing no car (0.44, 95% CI 0.24 to 0.80) or one car (0.60, 95% CI 0.42 to 0.87) compared with two or more cars, among council tenants (0.49, 95% CI 0.25 to 0.97), and among men living outside southern England (0.71, 95% CI 0.51 to 0.99). Only car ownership was related to the incidence of diagnostic angiography: the odds ratio for angiography for those owning fewer than two cars was 0.62 (95% CI 0.42 to 0.89).

CONCLUSION: During the 1990s, there were major inequalities in the probability of undergoing coronary revascularisation between British men according to socioeconomic status, age, and geographic location.

Original languageEnglish
Pages (from-to)635-40
Number of pages6
JournalHeart
Volume91
Issue number5
DOIs
Publication statusPublished - May 2005

Keywords

  • Age Factors
  • Aged
  • Angina Pectoris
  • Angioplasty, Balloon, Coronary
  • Coronary Artery Bypass
  • Follow-Up Studies
  • Great Britain
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction
  • Myocardial Revascularization
  • Proportional Hazards Models
  • Prospective Studies
  • Residence Characteristics
  • Socioeconomic Factors

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