For lifestyle recommendations, better be rich and well educated

Type of funding sources: None.

Management of cardiovascular risk factors (diabetes, hypertension, and high cholesterol levels) should start by implementing a healthy lifestyle. Whereas lifestyle recommendations are provided irrespective of the patient’s socio-economic status has not been recently assessed in the Brazilian population.

To assess the preventive measures against cardiovascular risk factors according to educational level and income in the Brazilian population.

We used survey data of the 2019 Brazilian National Health Survey (PNS). The PNS is a nationwide household-based survey carried out by the Brazilian Ministry of Health. The PNS included face-to-face interviews and collected information on lifestyle management of diabetes, hypertension and high cholesterol levels by a healthy diet, an adequate weight, and quitting smoking. Information on the participant’s educational level and income (in multiples of the basic salary per capita) was also collected.

Of the 81,197 participants included, 7,293 (9.0%), 23,065 (28.4%) and 13,304 (16.4%) reported being diagnosed with diabetes, hypertension, and high cholesterol levels, respectively. Dietary recommendations were the most frequently provided (94.8%, 94.6% and 88.6% for diabetes, hypertension, and high cholesterol levels, respectively), while recommendations to stop smoking were the least frequently provided (72.6%, 62.0% and 68.2% for diabetes, hypertension and high cholesterol levels, respectively). After multivariate adjustment, participants with a higher educational level or a higher income had a higher likelihood of being given lifestyle recommendations for hypertension or high cholesterol, while no significant trends were found for most recommendations for diabetes; see table, significant (p<0.05) trends are in grey background.

Better educated, wealthier Brazilians benefit more from lifestyle recommendations regarding cardiovascular risk factor management. This could impact the incidence of CVD according to socioeconomic groups.