The influence of socioeconomic status and sex in a network analysis on risk factors in CAD patients: The THORESCI study

Research output: Contribution to journalMeeting AbstractOther research output



A variety of risk factors (i.e., psychosocial, biomedical, socioeconomic status [SES] and health behavioral) influences the risk of development and prognosis of coronary artery disease (CAD), health and healthcare use both independently as well as mutually. Low SES was previously found to worsen the other risk factors, indicating it could be an influential factor. Additionally, sex differences were similarly found to exist in each separate risk factor. Network analysis could provide an in-depth insight in the interrelatedness of the risk factors with the moderating role of sex to ultimately contribute to more refinement in prevention and cardiac rehabilitation strategies.


1682 participants (77.9% male; Mage = 69.2 ± 10.6) with
established CAD completed questionnaires on psychosocial factors
and health behaviors at multiple timepoints. Biomedical data was
retrieved through medical records. An SES index was created based
on self-reported occupation and education, and area-based median
income through postal code. Using R, we conducted a mixed
graphical model network analysis on all risk factors combined with
and without the moderating role of sex.

SES belonged to the more influential risk factors with moderate to high levels of expected influence and degree centrality, indicating it plays a considerate role in the risk factor network. When considering the moderating role of sex, relationships between SES and the majority of the risk factors were found to be stronger for women.


The current study provided an insight in an interrelated network of a variety of risk factors among CAD patients. With SES belonging to the more influential risk factors and female sex influencing the strength of most of the SES-risk factor relationships, cardiac rehabilitation and prevention techniques could be more
refined by accounting for both influences.
Original languageEnglish
Article number1472
Pages (from-to)A118-A119
JournalPsychosomatic Medicine
Issue number5
Publication statusPublished - 2022


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