Cardiovascular disease is not shared equally across socioeconomic classes, as wealthier people are less prone to poor heart health. Some studies of cholesterol, one of the risk factors for heart disease, have linked higher cholesterol levels to lower socio-economic status, yet other studies have come to the opposite conclusion. What’s the truth? A new study conducted by researchers at University of Cambridge used not one but several measures of socio-economic status and found women, overall, had higher total cholesterol levels than men.

However, the study also discovered women with lower educational achievement tended to have higher total cholesterol levels when compared to others of their sex. Men also demonstrated slight differences when compared one against the other; those who performed manual labor had lower total cholesterol levels than men in other occupations. “If we wish to reduce health inequalities we need to understand the reason for these health inequalities,” said Dr. Kay-Tee Khaw, professor of clinical gerontology at University of Cambridge and lead researcher. “Future studies need to look at men and women separately and explore the reasons for these sex differences.”

Khaw and a team of researchers performed the current study as a substudy within the European Prospective into Cancer. A total of 22,451 participants between the ages of 39 and 79 completed a survey that measured socioeconomic status using three factors: social class, education level, and the level of deprivation in the area they lived. Each participant also indicated their alcohol consumption. BMI was calculated for each participant and blood samples taken to determine the following lipid levels: total cholesterol, HDL-cholesterol, triglycerides, and LDL-cholesterol.

Women had higher total cholesterol levels than men and women with less education had higher total cholesterol than others of their sex. Men in manual jobs were found to have slightly lower total cholesterol than those in other occupations, however, they had a worse overall cholesterol profile — though their "bad" cholesterol was lower than that of men in non-manual jobs so was their “good” cholesterol. To the researchers, this suggested the men in manual jobs might still be at an increased risk for heart disease.

"We observed sex differences in the lipid patterns according to social class and education,” said Khaw. However, the researchers found the relationship between cholesterol with socioeconomic status to be more evident in women than in men. Considering the entire picture, the authors concluded, “the variations in lipid profile with socio-economic status may be largely attributed to potentially modifiable factors such as obesity, physical activity and dietary intake.”

Source: Shohaimi S, Boekholdt MS, Luben R, et al. Distribution of lipid parameters according to different socio-economic indicators- The EPIC-Norfolk prospective population study. BMC Public Health. 2014.