Background:
Although the association between socioeconomic adversity and risk for cardiovascular disease (CVD) is established, little is known about the effect of socioeconomic disadvantages across the life-course on arterial stiffness, an important marker of subclinical cardiovascular disease (CVD).
Objective:
To investigate whether exposure to adverse socioeconomic position (SEP) throughout the life course and especially in early life, is associated with increased arterial stiffness in adults. In addition, we assessed whether increasing number of unfavorable SEP events during the life course is associated with higher arterial stiffness.
Methods:
A total of 14,497 adults from the ELSA-Brasil cohort study baseline (2008-2010), aged between 34 and 75 years (45.5% men, mean age: 51.9, SD: 9.09), with validated values of femoral carotid pulse wave velocity (cfPWV), and with information available about maternal education were included. ELSA-Brazil is a multicenter cohort of civil servants from universities and research institutions of six Brazilian cities that aims to investigate the determinants of cardiovascular disease. Arterial stiffness was measured by cfPWV. Childhood and adulthood SEP was measured by maternal education and participants’ own education, respectively. Accumulation of SEP disadvantages across the life course was evaluated using a score including maternal and participants’ own education. The following variables were used for adjustments: age, sex, race, mean arterial pressure, heart rate, smoking, physical activity, diabetes, antihypertensive use. Multiple linear regression models were used.
Results:
Both lower childhood and adulthood SEP were associated with higher cfPWV in adult life, although the association with childhood SEP was not independent of adulthood SEP. However, cfPWV increased with increasing number of unfavorable SEP during the life course. Individuals exposed to low SEP in childhood and adulthood presented an average increase of 0.23m/s (95% CI: 0.13-0.34) in cfPWV in relation to individuals with high SEP in both periods of life. After all adjustments this association remained statically significant (β = 0.18, 95% CI: 0.07-0.29).
Conclusion:
Accumulation of exposures to socioeconomic disadvantages throughout life was associated with higher cfPWV in adults. Thus, it may imply that longer exposure to social disadvantages throughout life accelerates arterial aging.
Sex-specific associations of adiposity with cardiometabolic traits: multi-life-stage cohort study with repeat metabolomics
