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The role of preclinical atherosclerosis in the explanation of educational differences in incidence of coronary events.

Rosvall, Maria LU ; Engström, Gunnar LU ; Hedblad, Bo LU ; Janzon, Lars LU and Berglund, Göran LU (2006) In Atherosclerosis 187(2). p.251-256
Abstract
The associations between educational level, preclinical carotid atherosclerosis and incident coronary events (CE), were investigated in a general population sample of 5399 Swedish middle-aged men and women without history of cardiovascular disease (CVD) over a median follow-up of 8.7 years. Presence of carotid plaque (focal intima-media thickness (IMT) >1.2 mm) was determined by B-mode ultrasound. In the age- and sex-adjusted model, there was an inverse relationship between educational level and risk of future CE (p for trend = 0.002). To explore if there were education differences between groups with similar degrees of preclinical carotid atherosclerosis stratified analyses were made. Those with low educational level without carotid... (More)
The associations between educational level, preclinical carotid atherosclerosis and incident coronary events (CE), were investigated in a general population sample of 5399 Swedish middle-aged men and women without history of cardiovascular disease (CVD) over a median follow-up of 8.7 years. Presence of carotid plaque (focal intima-media thickness (IMT) >1.2 mm) was determined by B-mode ultrasound. In the age- and sex-adjusted model, there was an inverse relationship between educational level and risk of future CE (p for trend = 0.002). To explore if there were education differences between groups with similar degrees of preclinical carotid atherosclerosis stratified analyses were made. Those with low educational level without carotid plaque showed a slightly increased hazard rate ratio (HRR), 1.14 (95% CI: 0.65, 1.97), compared to those with high educational level without carotid plaque (reference group). For those with high educational level with carotid plaque the HRR was 1.53 (95% CI: 0.92, 2.55). Having both low educational level and carotid plaque was associated with a HRR of 2.72 (95% CI: 1.72, 4.31). Individuals with plaque generally had more unfavourable cardiovascular risk factor levels, regardless of educational level. However, after risk factor adjustment those with both low education and carotid plaque still had a two-fold increased risk of CE. The results imply that differences in the prevalence of preclinical atherosclerosis seem important in explaining education differences in future coronary morbidity. (Less)
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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Incidence, Coronary disease, Atherosclerosis, Carotid arteries, Socioeconomic factors, Ultrasound
in
Atherosclerosis
volume
187
issue
2
pages
251 - 256
publisher
Elsevier
external identifiers
  • wos:000239368000003
  • scopus:33745486225
ISSN
1879-1484
DOI
10.1016/j.atherosclerosis.2005.08.037
language
English
LU publication?
yes
id
ef0c01d2-f009-46a3-8438-a51d739ace61 (old id 144463)
date added to LUP
2016-04-01 12:30:46
date last changed
2022-01-27 06:05:22
@article{ef0c01d2-f009-46a3-8438-a51d739ace61,
  abstract     = {{The associations between educational level, preclinical carotid atherosclerosis and incident coronary events (CE), were investigated in a general population sample of 5399 Swedish middle-aged men and women without history of cardiovascular disease (CVD) over a median follow-up of 8.7 years. Presence of carotid plaque (focal intima-media thickness (IMT) >1.2 mm) was determined by B-mode ultrasound. In the age- and sex-adjusted model, there was an inverse relationship between educational level and risk of future CE (p for trend = 0.002). To explore if there were education differences between groups with similar degrees of preclinical carotid atherosclerosis stratified analyses were made. Those with low educational level without carotid plaque showed a slightly increased hazard rate ratio (HRR), 1.14 (95% CI: 0.65, 1.97), compared to those with high educational level without carotid plaque (reference group). For those with high educational level with carotid plaque the HRR was 1.53 (95% CI: 0.92, 2.55). Having both low educational level and carotid plaque was associated with a HRR of 2.72 (95% CI: 1.72, 4.31). Individuals with plaque generally had more unfavourable cardiovascular risk factor levels, regardless of educational level. However, after risk factor adjustment those with both low education and carotid plaque still had a two-fold increased risk of CE. The results imply that differences in the prevalence of preclinical atherosclerosis seem important in explaining education differences in future coronary morbidity.}},
  author       = {{Rosvall, Maria and Engström, Gunnar and Hedblad, Bo and Janzon, Lars and Berglund, Göran}},
  issn         = {{1879-1484}},
  keywords     = {{Incidence; Coronary disease; Atherosclerosis; Carotid arteries; Socioeconomic factors; Ultrasound}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{251--256}},
  publisher    = {{Elsevier}},
  series       = {{Atherosclerosis}},
  title        = {{The role of preclinical atherosclerosis in the explanation of educational differences in incidence of coronary events.}},
  url          = {{https://lup.lub.lu.se/search/files/2953497/625005.pdf}},
  doi          = {{10.1016/j.atherosclerosis.2005.08.037}},
  volume       = {{187}},
  year         = {{2006}},
}