Socioeconomic status and risk of cardiovascular diseases in patients with retinal vein occlusion: A Danish nationwide cohort study

Abstract

Purpose

This study examines the association between socioeconomic status and the occurrence of both cardiovascular diseases and mortality following retinal vein occlusion (RVO), a condition known to elevate the risk of cardiovascular health issues. Despite recognition of the impact socioeconomic factors might have on a patient's course through the healthcare system, its association with cardiovascular outcomes post-RVO has not previously been thoroughly explored.

Design

Nationwide cohort study.

Methods

We included all subjects with RVO from the Danish nationwide registries diagnosed between 2000 and 2018. Information was combined using a personal identification number each Danish resident is given at birth or upon immigration. We categorized participants by their socioeconomic levels to evaluate the five-year incidence rate of cardiovascular conditions and overall mortality. The analysis was further refined by sex and age groups to elucidate any differential impacts. Furthermore, the cumulative incidence was estimated using the Aalen-Johansen estimator and the differences between the socioeconomic groups were quantified using a cox proportional hazard model. Key quantitative results were summarized, including hazard rate ratios (HR), confidence intervals (CI), and p-values

Results

The cohort was comprised of 14,041 individuals with RVO. Our analysis revealed a relationship between educational attainment and cardiovascular health outcomes. Lower education levels were consistently linked with heightened risks of mortality, diabetes, ischemic heart disease, myocardial infarction, and peripheral artery disease following RVO. Individuals with a middle educational level also exhibited a higher prevalence of peripheral artery disease when compared to those with the highest education levels. In terms of income, the lowest earners faced increased risks across several categories, including mortality, diabetes, heart failure, ischemic heart disease, myocardial infarction, and peripheral artery disease, when compared to the highest-income earners. The middle-income group also showed elevated risks for mortality, heart failure, and peripheral artery disease. Being unmarried was additionally associated with higher risks of mortality and heart failure compared to being married.

Conclusion

Socioeconomic status was significantly associated with clinically relevant differences in post-RVO risk of cardiovascular diseases and death. Our data suggests that socioeconomic factors should be considered in the attempt to reduce the risk of cardiovascular disease and death in patients with RVO.