Gender and Educational Trends in Lifetime Risk, Age at Onset, Expectancy, and Survival With Cardiovascular Disease in Finland, 1996-2020.

Abstract

Objectives: Cardiovascular disease (CVD) is the leading cause of mortality globally. Examining trends in CVD burden and associated sociodemographic disparities can contribute to tailoring policies that promote cardiovascular health and narrow health disparities. However, existing studies predominantly focus only on mortality. Therefore, we provide a more comprehensive understanding of CVD trends by studying the diverse aspects of CVD burden: lifetime risk, onset age, CVD-free and CVD life expectancy, and survival with CVD. We focus on the overall Finnish population in 1996-2020, as well as gender and educational disparities.

Methods: We use sociodemographic information from individual-level population registers, which are linked to hospital discharge and Death Registers, on the entire Finnish population aged 40-100 years in five five-year periods in 1996-2020 (N = 2,796,732-3,273,232). We employed multistate models to derive the study metrics.

Results: Overall, CVD's lifetime risk stabilizes at 72% following a rise, with onset age and CVD-free life expectancy increased by 3 years. Although men bear a higher CVD burden, they experience a greater increase in onset age and CVD-free expectancy than women. Educational disparities in CVD-free expectancy persist, exceeding 3.5 years for men and women. Furthermore, survival with CVD has extended by 2.8 years but educational disparities widen.

Discussion: Despite the encouraging CVD trends in the overall population and progress in narrowing gender disparities, there remains considerable room for further improvement. Persistent educational disparities in CVD burden underscore the need for more effective interventions to address enduring inequalities.