{
  "abstract": "Objectives Myocardial infarction (MI) is a major contributor to global disease burden with societal impact among survivors. This study aimed to estimate the population-level prevalence of MI among working-age adults in Spain and to examine associated sociodemographic, lifestyle, clinical and occupational factors focusing on sex differences.Design Two-phase population-based study using data from the 2020 Spanish European Health Interview Survey, including adults of working age. First, weighted estimates were used to calculate the population-level prevalence and describe sociodemographic characteristics. Second, a matched cross-sectional analysis was performed to examine associations between MI and sociodemographic, lifestyle, clinical and occupation-related factors using logistic regression models, including sex-stratified analyses.Setting Population-based study in Spain.Participants A total of 400 participants from the Spanish European Health Interview Survey were included, of whom 80 reported MI.Primary and secondary outcome measures Primary outcomes were the prevalence of self-reported MI and its association with sociodemographic characteristics, lifestyle behaviours, comorbidities and working conditions; secondary outcomes included healthcare utilisation and employment-related absences.Results 80 participants reported having a history of MI, corresponding to an estimated 137 646 working-age adults in Spain and a prevalence of 5.45 per 1000 population (95% CI 5.44 to 5.48), predominantly affecting men (74.2%) with a mean age of 52.7 years. MI prevalence was higher among individuals with lower educational attainment (OR 0.50; 95% CI 0.25 to 1); however, no employment-related factors remained associated with MI after adjustment. Sex-stratified analyses revealed that depression (OR 6.75; CI 2.23 to 20.4), obesity (OR 6.36; 95% CI 1.62 to 24.9) and COPD (OR 27.7; 95% CI 4.21 to 749) were more strongly associated with MI among women, while anxiety (OR 8.65; 95% CI 3.09 to 26.8) and hypertension (OR 4.11; 95% CI 2.24 to 7.62) among men.Conclusions MI among working-age adults in Spain is uncommon but concentrated among men with lower levels of education. The absence of independent associations with employment conditions and the presence of sex-specific comorbidity patterns highlight the need for gender-sensitive cardiovascular prevention strategies.",
  "authors": [
    {
      "affiliations": [
        "Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain",
        "Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain"
      ],
      "name": "Caterina Checa"
    },
    {
      "affiliations": [
        "Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain",
        "Hospital Clínic de Barcelona, Cardiovascular Institute, Barcelona, Spain"
      ],
      "name": "Carles Falces"
    },
    {
      "affiliations": [
        "Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain",
        "School of Nursing, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain",
        "Nursing Care Research, Institut de Recerca Sant Pau (IR Sant Pau), Sant Quintí 77-79, 08041, Barcelona, Spain"
      ],
      "name": "Rosalia Santesmases"
    },
    {
      "affiliations": [
        "Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain",
        "Consorci d'Atenció Primària de Salut Barcelona Esquerra (CAPSBE), Barcelona, Spain",
        "Nursing Department of Public Health, Mental Health and Mother and Child Health, Universitat de Barcelona (UB), Barcelona, Spain"
      ],
      "name": "Luis González-de Paz"
    }
  ],
  "title": "Occupational factors and sex differences after myocardial infarction in working-age adults in Spain: a population-based cross-sectional study",
  "uid": "f6e34dfe-fe90-5934-ae9f-69cbea7b7635"
}