Sociodemographic factors associated with major adverse cardiovascular events in the Ñuble Region in Chile: an ecological study

BACKGROUND: Cardiovascular diseases are the leading cause of death globally. In Chile, the Ñuble Region shows the highest national Cardiovascular diseases mortality rate, highlighting the need for local analyses. Major adverse cardiovascular events, including myocardial infarction, stroke, and heart failure, are key indicators of cardiovascular risk. This study aimed to identify sociodemographic factors associated with Major adverse cardiovascular events rates across Ñuble's 21 municipalities from 2011 to 2021.

METHODS: This ecological study used hospital discharge data, calculating Major adverse cardiovascular events rates per 1,000 inhabitants weighted by the public health-insured population. Variables included rurality, health expenditures, and municipal health contributions. Statistical analyses involved Spearman correlation, forward selection regression, and multvariate modeling using SAS 9.4.

RESULTS: There were 20,063 Major adverse cardiovascular events discharges, with a mean rate of 4.85 per 1,000. Health expenditure (ρ = -0.30), rurality (ρ = -0.15), and municipal contribution (ρ = -0.17) were inversely correlated with MACE rates (p < 0.05). In multivariate analysis (R² = 0.699), these remained significant.

CONCLUSION: Greater rurality, higher health spending, and increased municipal investment were associated with lower Major adverse cardiovascular events rates. These findings emphasize the importance of local health investment in reducing cardiovascular risk.