Aims: Spatial socioeconomic deprivation and rurality predict the outcome of cardiovascular diseases. High-density lipoprotein lipid peroxidation (HDLox) is a novel marker of adverse cardiovascular prognosis and mirrors oxidative stress and inflammation. We studied the association of spatial socioeconomic deprivation and rurality with levels of HDLox to add evidence on spatial disparities among patients with CAD.

Methods: Patients with confirmed CAD were enrolled in a cross sectional study at two hospitals in Germany. Spatial socioeconomic deprivation and rurality were assessed on the level of postcode areas using the rurality-deprivation-score (RDS). A validated fluorometric cell-free assay based on oxidation of the fluorochrome Amplex Red was used to measure HDLox. We applied multivariable linear regression to calculate adjusted associations and to assess mediation of associations by smoking, hypertension, diabetes, obesity, and levels of cholesterol, LDL, and triglycerides.

Results: 812 patients were included. After adjusting for age group, sex, and hospital, we found higher levels of HDLox in socioeconomically deprived postal code areas (β=0.444, 95% CI 0.063 to 0.826, p=0.02), while there was no association with rurality (β=0.040, 95% CI -0.020 to 0.101, p=0.19). After mutually adjusting for deprivation and rurality, these associations did not change. Diabetes partially mediated the relationship of deprivation with HDLox.

Conclusions: Socioeconomic features of neighbourhoods may be related to oxidative stress and inflammation. These factors should be considered in risk evaluations and to assess needs for secondary prevention. Studying pathways leading to oxidative stress and inflammation such as diabetes may yield further insights into mechanisms of spatial health disparities.