Socioeconomic status and cardiovascular risk factors in the Czech Republic

Background: The association between socioeconomic status (SES) and clinical cardiovascular events is well established. However, little is known about the relationship between SES and subclinical myocardial damage, as assessed by a novel highly sensitive assay for cardiac troponin T (hs-cTnT). Methods: We conducted a cross-sectional analysis of 11,411 participants from the ARIC Study with no history of cardiovascular disease who had hs-cTnT measured at visit 2 (1990-1992). SES was defined using either annual household income, categorized as: low (<$16,000), mid-level ($16,000 - $34,999), high (≥ $35,000), or lifetime educational attainment, categorized as: low (<12th grade), mid-level (12th grade/some college) and high (college degree or higher). hs-cTnT was categorized as non-elevated (<14 ng/L) and elevated (≥ 14ng/L). Poisson regression was used to generate prevalence ratios for elevated hs-cTnT, separately by level of income and education after adjusting for demographic, clinical, and behavioral factors. Results: Persons with low income or low education were more likely to have subclinical myocardial damage as assessed by elevated hs-cTnT (≥14ng/L). Adjusted prevalence ratios for elevated troponin comparing low to high levels of income and education were 1.74 (95% CI: 1.32, 2.29) and 1.54 (95% CI: 1.21, 1.97), respectively (Table, Model 1). These results were slightly attenuated, but remained statistically significant after adjusting for cardiovascular risk factors and health behaviors (Models 2 and 3). Race-stratified results demonstrate a somewhat stronger and only significant association of low education with subclinical myocardial damage in blacks compared to whites (PR 1.83 vs 1.05, p-interaction =0.08). There was no race interaction with income (p-interaction =0.33). Conclusions: Low SES was associated with elevated hs-cTnT, independent of cardiovascular risk factors, especially in blacks. Further research is needed to explore how low SES contributes to subclinical myocardial damage.

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Stress Responsivity and Body Fatness: Links between Socioeconomic Status and Cardiovascular Risk Factors in Youth

Annals of the New York Academy of Sciences ◽

10.1111/j.1749-6632.1999.tb08163.x ◽

1999 ◽

Vol 896 (1) ◽

pp. 435-438 ◽

Cited By ~ 10

Author(s):

FRANK TREIBER ◽

GREGORY HARSHFIELD ◽

HARRY DAVIS ◽

GASTON KAPUKU ◽

DONNA MOORE

Keyword(s):

Risk Factors ◽

Socioeconomic Status ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Body Fatness ◽

Stress Responsivity

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Low Socioeconomic Status Is Associated with Cardiovascular Risk Factors and Outcomes in Systemic Lupus Erythematosus

The Journal of Rheumatology ◽

10.3899/jrheum.110724 ◽

2012 ◽

Vol 39 (4) ◽

pp. 777-783 ◽

Cited By ~ 17

Author(s):

JANET W. MAYNARD ◽

HONG FANG ◽

MICHELLE PETRI

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Socioeconomic Status ◽

Cardiovascular Risk ◽

African Americans ◽

Cardiovascular Risk Factors ◽

Low Income ◽

Lupus Erythematosus ◽

Systemic Lupus ◽

Low Education

Objective.Accelerated atherosclerosis is a major cause of death in systemic lupus erythematosus (SLE), yet little is known about the effect of socioeconomic status. We investigated whether education or income levels are associated with cardiovascular risk factors and outcomes in SLE.Methods.Our study involved a longitudinal cohort of all patients with SLE enrolled in the Hopkins Lupus Cohort from 1987 through September 2011. Socioeconomic status was measured by education level (≥ 12 years or < 12) and income tertiles (> $60,000, $25,000–$60,000, or < $25,000).Results.A total of 1752 patients with SLE were followed prospectively every 3 months. There were 1052 whites and 700 African Americans. Current smoking, obesity, hypertension, and diabetes mellitus were more common in African Americans (p < 0.01 for all), but there was no statistical difference in the frequency of myocardial infarction or stroke. In multivariate analyses stratified by ethnicity, low income was strongly associated with most traditional cardiovascular risk factors in whites, but only with smoking and diabetes in African Americans. In whites, low income increased the risk of both myocardial infarction (OR 3.24, 95% CI 1.41–7.45, p = 0.006) and stroke (OR 2.85, 95% CI 1.56–5.21, p = 0.001); in African Americans, these relationships were not seen. Low education, in contrast, was associated with smoking in both ethnic groups.Conclusion.Low income, not low education, is the socioeconomic status variable associated with cardiovascular risk factors and events. This association is most clearly demonstrable in whites.

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