Combined effect of educational status and cardiovascular risk factors on the incidence of coronary heart disease and stroke in European cohorts: Implications for prevention
| Autor: | Giancarlo Cesana, Lloyd E. Chambless, Hugh Tunstall-Pedoe, Veikko Salomaa, Giovanni Veronesi, Annette Peters, Martin Bobak, Simona Giampaoli, Marco M Ferrario, Frank Kee, Stefan Söderberg, Abdonas Tamosiunas, Kari Kuulasmaa, Philippe Amouyel, Torben Jørgensen, Dominique Arveiler, Jean Ferrières |
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| Přispěvatelé: | Veronesi, G, Tunstall Pedoe, H, Ferrario, M, Kee, F, Kuulasmaa, K, Chambless, L, Amouyel, P, Arveiler, D, Bobak, M, Ferrieres, J, Giampaoli, S, Jørgensen, T, Peters, A, Salomaa, V, Soderberg, S, Tamosiunas, A, Cesana, G |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male additive interaction Gerontology medicine.medical_specialty Epidemiology Blood Pressure Coronary Disease Disease 030204 cardiovascular system & hematology Overweight competing risk Cohort Studies Social inequalitie 03 medical and health sciences 0302 clinical medicine Risk Factors differential vulnerability medicine Humans 030212 general & internal medicine Intensive care medicine Stroke Aged competing risks business.industry Incidence Incidence (epidemiology) Body Weight Smoking Absolute risk reduction Middle Aged medicine.disease Obesity cardiovascular disease risk Europe Social inequalities Blood pressure Cardiovascular Diseases Educational Status Female medicine.symptom Cardiology and Cardiovascular Medicine business Social status |
| Zdroj: | Veronesi, G, Tunstall-Pedoe, H, Ferrario, M M, Kee, F, Kuulasmaa, K, Chambless, L E, Amouyel, P, Arveiler, D, Bobak, M, Ferrieres, J, Giampaoli, S, Jørgensen, T, Peters, A, Salomaa, V, Soderberg, S, Tamosiunas, A, Cesana, G & MORGAM Project 2017, ' Combined effect of educational status and cardiovascular risk factors on the incidence of coronary heart disease and stroke in European cohorts : Implications for prevention ', European Journal of Preventive Cardiology, vol. 24, no. 4, pp. 437-445 . https://doi.org/10.1177/2047487316679521 |
| ISSN: | 2047-4881 2047-4873 |
| Popis: | BACKGROUND: The combined effect of social status and risk factors on the absolute risk of cardiovascular disease has been insufficiently investigated, but results provide guidance on who could benefit most through prevention.METHODS: We followed 77,918 cardiovascular disease-free individuals aged 35-74 years at baseline, from 38 cohorts covering Nordic and Baltic countries, the UK and Central Europe, for a median of 12 years. Using Fine-Gray models in a competing-risks framework we estimated the effect of the interaction of education with smoking, blood pressure and body weight on the cumulative risk of incident acute coronary heart disease and stroke.RESULTS: Compared with more educated smokers, the less educated had an added increase in absolute risk of cardiovascular disease of 3.1% (95% confidence interval + 0.1%, +6.2%) in men and of 1.5% (-1.9%, +5.0%) in women, consistent across smoking categories. Conversely, the interaction was negative for overweight: -2.6% (95% CI: -5.6%, +0.3%) and obese: -3.6% (-7.6%, +0.4%) men, suggesting that the more educated would benefit more from the same reduction in body weight. A weaker interaction was observed for body weight in women, and for blood pressure in both genders. Less educated men and women with a cluster of two or more risk factors had an added cardiovascular disease risk of 3.6% (+0.1%, +7.0%) and of 2.6% (-0.5%, +5.6%), respectively, compared with their more educated counterparts.CONCLUSIONS: Socially disadvantaged subjects have more to gain from lifestyle and blood pressure modification, hopefully reducing both their risk and also social inequality in disease. |
| Databáze: | OpenAIRE |
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