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Risk of major cardiovascular events according to educational level before and after the initial COVID-19 public lockdown: a nationwide study

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Harvard

Andersen, J, Strandberg-Larsen, K, Gerds, T, Gislason, G, Torp-Pedersen, C, Blanche, P, Andersson, C, Køber, L, Fosbøl, E, Phelps, M, Kragholm, K, Andersen, MP, Østergaard, L, Butt, J & Schou, M 2021, 'Risk of major cardiovascular events according to educational level before and after the initial COVID-19 public lockdown: a nationwide study', Journal of Epidemiology and Community Health, bind 75, nr. 9, s. 829-835. https://doi.org/10.1136/jech-2020-215133

APA

Andersen, J., Strandberg-Larsen, K., Gerds, T., Gislason, G., Torp-Pedersen, C., Blanche, P., Andersson, C., Køber, L., Fosbøl, E., Phelps, M., Kragholm, K., Andersen, M. P., Østergaard, L., Butt, J., & Schou, M. (2021). Risk of major cardiovascular events according to educational level before and after the initial COVID-19 public lockdown: a nationwide study. Journal of Epidemiology and Community Health, 75(9), 829-835. https://doi.org/10.1136/jech-2020-215133

CBE

MLA

Vancouver

Author

Andersen, Julie ; Strandberg-Larsen, Katrine ; Gerds, Thomas ; Gislason, Gunnar ; Torp-Pedersen, Christian ; Blanche, Paul ; Andersson, Charlotte ; Køber, Lars ; Fosbøl, Emil ; Phelps, Matthew ; Kragholm, Kristian ; Andersen, Mikkel Porsborg ; Østergaard, Lauge ; Butt, Jawad ; Schou, Morten. / Risk of major cardiovascular events according to educational level before and after the initial COVID-19 public lockdown : a nationwide study. I: Journal of Epidemiology and Community Health. 2021 ; Bind 75, Nr. 9. s. 829-835.

Bibtex

@article{68bc3c87e3d74409a7c86d01626f9e03,
title = "Risk of major cardiovascular events according to educational level before and after the initial COVID-19 public lockdown: a nationwide study",
abstract = "BACKGROUND: During the COVID-19 pandemic, decreasing rates of hospitalisations for cardiovascular disease raised concerns for undertreatment, particularly for vulnerable groups. We investigated how the initial COVID-19 public lockdown, impacted the risk of being hospitalised with a major cardiovascular event (MCE: myocardial infarction/stroke/heart failure) according to educational level.METHODS: We grouped all Danish residents according to educational attainment level (low, medium, high) and age (40-59, 60-69, ≥70 years). In each group, we calculated the age-standardised and sex standardised risk of MCE hospitalisation in the initial COVID-19 lockdown-period (13 March 2020-3 May 2020) and in the corresponding calendar period in 2019. We calculated age-standardised and sex-standardised risks to investigate whether the COVID-19 lockdown had a differential effect on MCE incidence according to educational level.RESULTS: In the period in 2019, 2700 Danish residents were hospitalised with MCE, compared with only 2290 during the lockdown. During lockdown, the risk of hospitalisation for MCE decreased among residents aged ≥70 with low education (risk difference (RD) -46.2 (-73.2; -19.2) per 100,000) or medium education (RD -23.2 (-50.8; 4.3) per 100 000), but not among residents with high education (RD 5.1 (-32.3; 42.5), per 100 000). The risk of hospitalisation for MCE did not decrease significantly for the younger age groups.CONCLUSIONS: The COVID-19 lockdown is associated with a reduced incidence for MCE, especially among low educated, elderly residents. This raises concern for undertreatment that without clinical awareness and action may widen the educational gap in cardiovascular morbidity and mortality.",
keywords = "Adult, Aged, COVID-19/epidemiology, Educational Status, Female, Heart Failure/epidemiology, Humans, Incidence, Male, Middle Aged, Myocardial Infarction/epidemiology, Pandemics/prevention & control, Quarantine, Risk Assessment, Stroke/epidemiology, public health policy, socio-economic, health policy, social inequalities, public health",
author = "Julie Andersen and Katrine Strandberg-Larsen and Thomas Gerds and Gunnar Gislason and Christian Torp-Pedersen and Paul Blanche and Charlotte Andersson and Lars K{\o}ber and Emil Fosb{\o}l and Matthew Phelps and Kristian Kragholm and Andersen, {Mikkel Porsborg} and Lauge {\O}stergaard and Jawad Butt and Morten Schou",
note = "{\textcopyright} Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2021",
month = sep,
doi = "10.1136/jech-2020-215133",
language = "English",
volume = "75",
pages = "829--835",
journal = "Journal of Epidemiology & Community Health",
issn = "0143-005X",
publisher = "B M J Group",
number = "9",

}

RIS

TY - JOUR

T1 - Risk of major cardiovascular events according to educational level before and after the initial COVID-19 public lockdown

T2 - a nationwide study

AU - Andersen, Julie

AU - Strandberg-Larsen, Katrine

AU - Gerds, Thomas

AU - Gislason, Gunnar

AU - Torp-Pedersen, Christian

AU - Blanche, Paul

AU - Andersson, Charlotte

AU - Køber, Lars

AU - Fosbøl, Emil

AU - Phelps, Matthew

AU - Kragholm, Kristian

AU - Andersen, Mikkel Porsborg

AU - Østergaard, Lauge

AU - Butt, Jawad

AU - Schou, Morten

N1 - © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2021/9

Y1 - 2021/9

N2 - BACKGROUND: During the COVID-19 pandemic, decreasing rates of hospitalisations for cardiovascular disease raised concerns for undertreatment, particularly for vulnerable groups. We investigated how the initial COVID-19 public lockdown, impacted the risk of being hospitalised with a major cardiovascular event (MCE: myocardial infarction/stroke/heart failure) according to educational level.METHODS: We grouped all Danish residents according to educational attainment level (low, medium, high) and age (40-59, 60-69, ≥70 years). In each group, we calculated the age-standardised and sex standardised risk of MCE hospitalisation in the initial COVID-19 lockdown-period (13 March 2020-3 May 2020) and in the corresponding calendar period in 2019. We calculated age-standardised and sex-standardised risks to investigate whether the COVID-19 lockdown had a differential effect on MCE incidence according to educational level.RESULTS: In the period in 2019, 2700 Danish residents were hospitalised with MCE, compared with only 2290 during the lockdown. During lockdown, the risk of hospitalisation for MCE decreased among residents aged ≥70 with low education (risk difference (RD) -46.2 (-73.2; -19.2) per 100,000) or medium education (RD -23.2 (-50.8; 4.3) per 100 000), but not among residents with high education (RD 5.1 (-32.3; 42.5), per 100 000). The risk of hospitalisation for MCE did not decrease significantly for the younger age groups.CONCLUSIONS: The COVID-19 lockdown is associated with a reduced incidence for MCE, especially among low educated, elderly residents. This raises concern for undertreatment that without clinical awareness and action may widen the educational gap in cardiovascular morbidity and mortality.

AB - BACKGROUND: During the COVID-19 pandemic, decreasing rates of hospitalisations for cardiovascular disease raised concerns for undertreatment, particularly for vulnerable groups. We investigated how the initial COVID-19 public lockdown, impacted the risk of being hospitalised with a major cardiovascular event (MCE: myocardial infarction/stroke/heart failure) according to educational level.METHODS: We grouped all Danish residents according to educational attainment level (low, medium, high) and age (40-59, 60-69, ≥70 years). In each group, we calculated the age-standardised and sex standardised risk of MCE hospitalisation in the initial COVID-19 lockdown-period (13 March 2020-3 May 2020) and in the corresponding calendar period in 2019. We calculated age-standardised and sex-standardised risks to investigate whether the COVID-19 lockdown had a differential effect on MCE incidence according to educational level.RESULTS: In the period in 2019, 2700 Danish residents were hospitalised with MCE, compared with only 2290 during the lockdown. During lockdown, the risk of hospitalisation for MCE decreased among residents aged ≥70 with low education (risk difference (RD) -46.2 (-73.2; -19.2) per 100,000) or medium education (RD -23.2 (-50.8; 4.3) per 100 000), but not among residents with high education (RD 5.1 (-32.3; 42.5), per 100 000). The risk of hospitalisation for MCE did not decrease significantly for the younger age groups.CONCLUSIONS: The COVID-19 lockdown is associated with a reduced incidence for MCE, especially among low educated, elderly residents. This raises concern for undertreatment that without clinical awareness and action may widen the educational gap in cardiovascular morbidity and mortality.

KW - Adult

KW - Aged

KW - COVID-19/epidemiology

KW - Educational Status

KW - Female

KW - Heart Failure/epidemiology

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Myocardial Infarction/epidemiology

KW - Pandemics/prevention & control

KW - Quarantine

KW - Risk Assessment

KW - Stroke/epidemiology

KW - public health policy

KW - socio-economic

KW - health policy

KW - social inequalities

KW - public health

UR - http://www.scopus.com/inward/record.url?scp=85112722558&partnerID=8YFLogxK

U2 - 10.1136/jech-2020-215133

DO - 10.1136/jech-2020-215133

M3 - Journal article

C2 - 33542032

VL - 75

SP - 829

EP - 835

JO - Journal of Epidemiology & Community Health

JF - Journal of Epidemiology & Community Health

SN - 0143-005X

IS - 9

ER -

ID: 62236621