Research, Patient care / 07.03.2025
Inequality raises disease risk, especially for women

A study led by researchers at the Max Delbrück Center has found that low socioeconomic status raises the risk of cardiovascular disease in women more so than in men. The study underlines the importance of gender-specific prevention.

A growing number of studies are reporting gender differences in diseases such as stroke, heart attack and high blood pressure. “It is known from previous studies that a lower socioeconomic status is associated with a higher cardiovascular risk. The relationship between social status and the cardiovascular risk profile, and in particular whether this relationship differs between men and women, has been insufficiently researched in Germany to date,” says Professor Dr. Tobias Pischon, an author of the publication and member of the Board of Directors of NAKO e.V. The German National Cohort (NAKO) is Germany's largest long-term study on the development of diseases.

The researchers analyzed data from 204,780 participants in the NAKO collected between 2014-2019 – 50% of the participants are women. The analysis was based on self-reported information on socioeconomic factors such as education, income and employment status, the use of antihypertensive medication, chronic cardiovascular and metabolic conditions, lifestyle factors such as smoking and alcohol consumption, as well as measured values from medical examinations at the NAKO study centers, such as blood pressure, blood test results and other measurements. The scientists took various other factors into account in the calculations.

Heart attack, high blood pressure, overweight

The study found that women with low socioeconomic status were more likely to have an adverse cardiovascular risk profile compared to a comparable group of men and women with high socioeconomic status. “In women compared with men, low socioeconomic status was more strongly associated with myocardial infarction, hypertension, obesity, use of antihypertensive medication and risky alcohol consumption, but – in contrast to men – less strongly associated with active or former smoking,” says Dr. Ilais Moreno Velásquez, scientist at the Max Delbrück Center in Berlin-Buch and lead author of the study. In addition, “compared to those with a high socioeconomic status, women with low education and income had higher odds of a high 10-year risk of cardiovascular events than men of comparable socioeconomic status.”

Pischon and his team plan to investigate the correlations further: “In our current evaluation, we have estimated the risk of future cardiovascular events on the basis of internationally established algorithms. With the many scientifically valuable data that we are gaining from the NAKO study through repeated examination of study participants, we will be able to check these results in the future with regard to newly diagnosed cardiovascular diseases. Overall, however, our results already indicate that the risk of cardiovascular disease in women is more strongly dependent on social status than in men. For our health policy in Germany, this underscores the importance of taking social inequalities into account in cardiovascular disease prevention strategies,” says Pischon.