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Socioeconomic differences in the progression of carotid atherosclerosis in middle-aged men and women with subclinical atherosclerosis in Sweden.

Rosvall, Maria LU ; Östergren, Per-Olof LU ; Hedblad, Bo LU ; Isacsson, Sven-Olof LU ; Janzon, Lars LU and Berglund, Göran LU (2006) In Social Science and Medicine 62(7). p.1785-1798
Abstract
While the persistence of socioeconomic differences in cardiovascular disease (CVD) has been recognized for many years, less is known about whether socioeconomic factors are of importance to CVD before symptoms of the disease appear. In this study the associations among educational level, occupational status and progression of atherosclerosis were investigated in 1016 Swedish middle-aged men and women with signs of subclinical atherosclerosis, i.e., carotid plaque (defined as focal intima-media thickness (IMT) >1.2 mm). IMT in the common carotid artery (CCA) and in the carotid bifurcation area, as well as carotid plaque score, was determined by B-mode ultrasound. Results showed only weak associations between educational level,... (More)
While the persistence of socioeconomic differences in cardiovascular disease (CVD) has been recognized for many years, less is known about whether socioeconomic factors are of importance to CVD before symptoms of the disease appear. In this study the associations among educational level, occupational status and progression of atherosclerosis were investigated in 1016 Swedish middle-aged men and women with signs of subclinical atherosclerosis, i.e., carotid plaque (defined as focal intima-media thickness (IMT) >1.2 mm). IMT in the common carotid artery (CCA) and in the carotid bifurcation area, as well as carotid plaque score, was determined by B-mode ultrasound. Results showed only weak associations between educational level, occupational status and age-, sex- and baseline IMT-adjusted progression of IMT in the CCA. However, in the age, sex- and baseline IMT-adjusted analyses, those in unskilled manual occupations showed a significantly higher yearly progression of carotid IMT in the bifurcation area compared to those in high- or medium-level non-manual occupations. Those with primary education tended to show a higher yearly progression of carotid IMT in the bifurcation area compared to those with completed secondary education. After adjustment for risk factors, the magnitude of these associations were somewhat attenuated. Similar patterns of associations were seen for the change of carotid plaque score.



We conclude that low socioeconomic status (SES) is associated with progression of atherosclerosis in a middle-aged population with signs of subclinical atherosclerosis. Even though socioeconomic differences in cardiovascular risk factor levels could explain part of the found differences in progression rate in women, the mechanisms involved remain to be further established. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Sex factors, Atherosclerosis, Carotid arteries, Socioeconomic factors, Sweden
in
Social Science and Medicine
volume
62
issue
7
pages
1785 - 1798
publisher
Elsevier
external identifiers
  • wos:000236488600018
  • pmid:16181715
  • scopus:32644434857
ISSN
1873-5347
DOI
10.1016/j.socscimed.2005.08.037
language
English
LU publication?
yes
id
1a16b6f7-8d23-4426-8d7e-23a2d1f49f36 (old id 143465)
date added to LUP
2016-04-01 11:42:30
date last changed
2019-09-11 01:30:15
@article{1a16b6f7-8d23-4426-8d7e-23a2d1f49f36,
  abstract     = {While the persistence of socioeconomic differences in cardiovascular disease (CVD) has been recognized for many years, less is known about whether socioeconomic factors are of importance to CVD before symptoms of the disease appear. In this study the associations among educational level, occupational status and progression of atherosclerosis were investigated in 1016 Swedish middle-aged men and women with signs of subclinical atherosclerosis, i.e., carotid plaque (defined as focal intima-media thickness (IMT) &gt;1.2 mm). IMT in the common carotid artery (CCA) and in the carotid bifurcation area, as well as carotid plaque score, was determined by B-mode ultrasound. Results showed only weak associations between educational level, occupational status and age-, sex- and baseline IMT-adjusted progression of IMT in the CCA. However, in the age, sex- and baseline IMT-adjusted analyses, those in unskilled manual occupations showed a significantly higher yearly progression of carotid IMT in the bifurcation area compared to those in high- or medium-level non-manual occupations. Those with primary education tended to show a higher yearly progression of carotid IMT in the bifurcation area compared to those with completed secondary education. After adjustment for risk factors, the magnitude of these associations were somewhat attenuated. Similar patterns of associations were seen for the change of carotid plaque score.<br/><br>
<br/><br>
We conclude that low socioeconomic status (SES) is associated with progression of atherosclerosis in a middle-aged population with signs of subclinical atherosclerosis. Even though socioeconomic differences in cardiovascular risk factor levels could explain part of the found differences in progression rate in women, the mechanisms involved remain to be further established.},
  author       = {Rosvall, Maria and Östergren, Per-Olof and Hedblad, Bo and Isacsson, Sven-Olof and Janzon, Lars and Berglund, Göran},
  issn         = {1873-5347},
  language     = {eng},
  number       = {7},
  pages        = {1785--1798},
  publisher    = {Elsevier},
  series       = {Social Science and Medicine},
  title        = {Socioeconomic differences in the progression of carotid atherosclerosis in middle-aged men and women with subclinical atherosclerosis in Sweden.},
  url          = {http://dx.doi.org/10.1016/j.socscimed.2005.08.037},
  doi          = {10.1016/j.socscimed.2005.08.037},
  volume       = {62},
  year         = {2006},
}