Impact of the COVID-19 pandemic on CVD prevention between different socioeconomic groups in Switzerland

Abstract

Background The COVID-19 pandemic disrupted the continuing management of cardiovascular disease (CVD) risk factors in the population. Socioeconomic status (SES) is a major determinant of health. Whether the COVID-19 pandemic increased, the SES gap in CVD risk factors is unknown.Aims To compare the management of CVD risk factors and the SES gap before and during the pandemic.Methods Cross-sectional study conducted between 2018 and 2021 in Lausanne, Switzerland. Prevalence, awareness, treatment and control rates of hypertension, dyslipidaemia and diabetes were compared between the periods before (N=2416, 45.2% men, 65.3±9.8 years) and during (N=776, 44.5% men, 63.9±9.1 years) the COVID-19 pandemic. SES was defined by education and categorised as low (compulsory or apprenticeship), middle (high school) and high (university).Results After multivariable analysis, the prevalence of hypertension increased, and awareness decreased during the pandemic: OR and (95% CI) 1.26 (1.04 to 1.53) and 0.70 (0.53 to 0.94), respectively. For dyslipidaemia, prevalence decreased during the pandemic 0.82 (95% CI 0.69 to 0.98); awareness did not change. For diabetes, prevalence did not change but awareness increased 5.76 (95% CI 1.23 to 27.04). No differences were found before and during the pandemic regarding treatment and control for all CVD risk factors. Relative to high SES, a decrease in hypertension awareness among middle SES categories was observed during the pandemic (OR and 95% CI 1.11 (0.73 to 1.69) before and 0.45 (95% CI 0.23 to 0.85) during, p for interaction<0.05), while no other changes were found.Conclusion Prevalence and management of CVD risk factors changed little during the pandemic. The SES gap did not increase except for hypertension awareness.