By helping people to change their lifestyles and increasing health education we can help turn the tide

Professor Sir Charles George

Between 1986 and 1995 a total of 44,465 Scottish men and 38,710 women died before being admitted to hospital after a first heart attack.

A further 68,626 men and 49,123 women were admitted to hospital, of whom 22% died within 30 days.

The research team, led by Professor John McMurray at the University of Glasgow, used postcodes and census information to assign a deprivation category for each individual.

The British Heart Foundation (BHF) which funded the project, said the findings reinforced existing observations.

Poverty and lifestyle

Professor Sir Charles George, BHF medical director, said that differences in social class between rich and poor are the cause of thousands of deaths from coronary heart disease in the UK each year.

He said: "It may seem obvious that social factors such as poverty and lifestyle would have an effect on the risk of heart disease, but now we can put a clear figure on their effect in Scotland and start to do more about them.

"People from lower socio-economic groups are more likely to smoke and less likely to eat fruit and vegetables than people from wealthier backgrounds.

"They may also be less likely to report any warning signs of coronary heart disease such as angina to their GP.

"By helping people to change their lifestyles and increasing health education we can help turn the tide on these figures and reduce the devastating burden of coronary heart disease in the UK - for everyone."

Smoking increases heart attack risk

The Health Development Agency (HDA) says the findings are not unexpected.

HDA Chief Executive Professor Richard Parish said: "Evidence shows that factors like education level, housing, diet and smoking habits impact on a person's health - this research now highlights the effect of these factors on the way a person will recover after having a heart attack.

"Inequalities in health exist - the death rate for unskilled men is three times higher than among professionals, a gap that has widened sharply in the last 20 years.

"We also know that differences in smoking account for at least half of the health inequalities between the poorest and the wealthiest in England.

"The inequalities targets now in place should help address this in time."

The research is published in the British Medical Journal.