Table 1

Baseline Characteristics, Clinical Features, Investigations, and Treatment According to Tertiles of Gini Coefficient

Gini Tertile 1Gini Tertile 2Gini Tertile 3
Least Inequality (n = 5,320)Intermediate Group (n = 6,124)Greatest Inequality (n = 3,772)
Baseline characteristics
 Gini coefficient<3333–41>41
 Number of countries181917
 Age, yrs66.3 ± 10.362.8 ± 11.661.0 ± 12.2
Age group, yrs
 ≤4078 (1.5)254 (4.1)215 (5.7)
 41-55690 (13.0)1,255 (20.5)963 (25.5)
 56-702,556 (48.0)2,932 (47.9)1,716 (45.5)
 >701,996 (37.5)1,683 (27.5)878 (23.3)
Females1,118 (21.0)1,273 (20.8)936 (24.8)
Region
 North America0 (0.0)779 (12.7)0 (0.0)
 Latin America0 (0.0)187 (3.1)2,365 (62.7)
 Western Europe and other2,315 (43.5)1,328 (21.7)311 (8.2)
 Central Europe2,570 (48.3)2,136 (34.9)64 (1.7)
 Asia-Pacific435 (8.2)1,694 (27.7)1,032 (27.4)
Per capita income, US$31,582 ± 18,67520,714 ± 17,7049,980 ± 5,706
Percentage of national GDP spent on health care9.1 ± 1.97.8 ± 3.46.8 ± 1.5
HDI0.890 (0.834–0.920)0.803 (0.676–0.877)0.737 (0.723–0.780)
 Education index0.847 (0.822–0.898)0.814 (0.635–0.852)0.664 (0.616–0.709)
 Life index0.924 (0.847–0.935)0.817 (0.740–0.931)0.855 (0.834–0.863)
 Income index0.865 (0.816–0.917)0.830 (0.657–0.879)0.725 (0.719–0.785)
Hospital beds per 1,0006.4 (6.0–8.2)2.9 (1.0–6.5)2.5 (1.6–3.8)
Health workers per 1,0006.0 (4.7–8.7)4.5 (1.4–6.1)1.9 (1.8–4.1)
SBP, mm Hg125 ± 16.9122 ± 16.5120 ± 16.3
HR, beats/min71.5 ± 12.872.5 ± 11.871.8 ± 12.2
BMI, kg/m228.6 ± 5.227.7 ± 5.826.9 ± 5.2
Weight category
 Underweight37 (0.7)179 (2.9)88 (2.3)
 Normal1,267 (23.8)1,877 (30.6)1,335 (35.4)
 Overweight2,158 (40.6)2,182 (35.6)1,448 (38.4)
 Obese1,853 (34.8)1,869 (30.5)894 (23.7)
Medical history
 Hypertension3,733 (70.2)4,072 (66.5)2,324 (61.6)
 Diabetes1,804 (33.9)2,011 (32.8)954 (25.3)
 Atrial fibrillation, ECG1,704 (32.0)1,254 (20.5)639 (16.9)
 Atrial fibrillation history2,496 (46.9)2,030 (33.2)885 (23.5)
 Unstable angina626 (11.8)788 (12.9)264 (7.0)
 Myocardial infarction2,292 (43.1)3,021 (49.3)1,111 (29.5)
 Stroke490 (9.2)466 (7.6)245 (6.5)
 COPD789 (14.8)820 (13.4)222 (5.9)
 Renal disease846 (15.9)929 (15.2)233 (6.2)
ECG findings
 LBBB1,023 (19.2)1,219 (21.6)815 (21.6)
 RBBB601 (11.3)564 (9.2)405 (10.7)
 QRS duration, ms119.9 ± 34.7114.9 ± 35.5116.5 ± 36.7
Smoking/alcohol
 Smoking status
  Never smoked2,536 (47.7)3,401 (55.5)2,129 (56.4)
  Ex-smoker1,970 (37.0)1,949 (31.8)1,175 (31.2)
  Current smoker814 (15.3)774 (12.6)468 (12.4)
 Alcohol, drinks/day
  <14,368 (82.1)5,496 (89.8)3,492 (92.6)
  1-2788 (14.8)521 (8.5)204 (5.4)
  >2164 (3.1)105 (1.7)76 (2.0)
Heart failure: clinical features, investigations, drugs and devices
Gini coefficient<3333–41>41
Time since HF diagnosis, yrs
 <11,526 (28.7)1,928 (31.5)1,357 (36.0)
 1-51,964 (36.9)2,278 (37.2)1,514 (40.1)
 >51,829 (34.4)1,915 (31.3)901 (23.9)
HF cause
 Ischemic3,251 (61.1)4,107 (67.1)1,521 (40.3)
 Nonischemic1,573 (29.6)1,428 (23.3)1,726 (45.8)
 Unknown496 (9.3)589 (9.6)525 (1.4)
Prior hospitalization for HF3,331 (62.6)3,686 (60.2)2,292 (60.8)
NYHA functional class§
 I/II3,748 (68.6)4,264 (69.7)3,231 (85.7)
 III1,627 (30.6)1,793 (29.3)520 (13.8)
 IV45 (0.9)58 (1.0)17 (0.5)
KCCQ, clinical summary score77.1 (60.4–90.0)76.0 (58.9–89.6)87.5 (75.0–95.8)
Dyspnea on effort4,642 (87.3)5,387 (88.2)2,997 (79.5)
Orthopnea267 (5.0)428 (7.0)272 (7.2)
PND345 (6.5)276 (4.5)129 (3.4)
Edema1,213 (22.8)1,437 (23.5)489 (13.0)
Third heart sound409 (7.7)748 (12.2)200 (5.3)
JVD590 (11.1)457 (7.5)422 (11.2)
LVEF29.9 ± 5.728.9 ± 6.128.0 ± 6.0
LVH852 (16.0)1,693 (27.6)950 (25.2)
NT-proBNP, pg/ml1,358 (766–2,540)1,424 (755–2,816)1,500 (803–3,130)
Hemoglobin, g/l140.6 ± 14.8136.7 ± 17.0138.8 ± 16.0
eGFR, ml/min per 1.73 m268.1 ± 19.870.3 ± 22.374.7 ± 24.6
eGFR, <60 ml/min per m21,861 (35.0)1,994 (32.6)981 (26.0)
Drug, devices, other therapy
 Diuretics4,342 (81.6)4,903 (80.1)2,945 (78.1)
 Digitalis1,374 (25.8)1,955 (31.9)1,395 (37.0)
 Beta-blocker4,995 (93.9)5,591 (91.3)3,489 (92.5)
 MRA2,381 (44.8)2,660 (43.4)2,162 (57.3)
 ACE inhibitor pre-randomization4,772 (89.7)5,434 (88.7)3,191 (84.6)
 ARB pre-randomization621 (11.7)717 (11.7)590 (15.6)
 Statin3,146 (59.1)3,741 (61.1)1,437 (38.1)
 Anticoagulants2,426 (45.6)1,717 (28.0)631 (16.7)
 Aspirin2,469 (46.4)3,393 (55.4)1,978 (52.4)
 Prior PCI1,384 (26.0)1,232 (20.1)510 (13.5)
 Prior CABG969 (18.2)1,015 (16.6)278 (7.4)
 Conventional pacemaker780 (14.7)709 (11.6)297 (7.9)
 ICD or CRT-D1,131 (21.3)986 (16.1)165 (4.4)
 CRT-P or CRT-D442 (8.3)417 (6.8)101 (2.7)

ACE inhibitor = angiotensin angiotensin-converting enzyme inhibitor; ARB = angiotensin receptor blocker; BMI = body mass index; CABG = coronary artery bypass graft; COPD = chronic obstructive pulmonary disease; CRT = cardiac resynchronization therapy; D = defibrillator; ECG = electrocardiography; eGFR = estimated glomerular filtration rate; GDP = gross domestic product; HDI = human development index; HF = heart failure; HR = heart rate; ICD = implantable cardioverter cardioverter-defibrillator; IQR = inter quartile range; JVD = jugular venous distension; KCCQ = Kansas City Cardiomyopathy Questionnaire; LBBB = left bundle branch block; LVEF = left ventricular ejection fraction; LVH = left ventricular hypertrophy; MRA = mineralocorticoid receptor antagonist; NT-proBNP = N terminal–pro B-type natriuretic peptide; NYHA = New York Heart Association; P = pacemaker; PCI = percutaneous coronary intervention; PND = paroxysmal nocturnal dyspnea; RBBB = right bundle branch block; SBP = systolic blood pressure; US$ = U.S. dollars.

Values are n (%), median (IQR), or mean ± SD.

  • Taking into account only physician and nurses/midwives' density per 1,000 population.

  • 29 were missing.

  • One drink equals 12 oz beer, 8 oz malt liquor, 5 oz wine, 1.5 ounces, or a shot of spirits or liquor.

  • § 13 values were missing.