Abstract P160: Is Higher Educational Attainment or Higher Income Protective for Cardiovascular Risk in Deaf American Sign Language (ASL) Users?

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Michael M McKee ◽  
Kimberly C McKee ◽  
Erika Sutter ◽  
Thomas Pearson
Keyword(s):  
High School ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
General Population ◽  
Educational Attainment ◽  
Sign Language ◽  
Household Income ◽  
Annual Household Income ◽  
Low Education ◽  
Higher Educational Attainment

Background: Deaf ASL users appear to be burdened with higher cardiovascular risk due to communication barriers in the health care setting and from lack of accessible health educational and outreach programs. It is well known among the general population that higher educational attainment and income are highly correlated and provide cardiovascular protection. It is unknown if the same effect is seen among Deaf ASL users. Objective We sought to examine whether educational attainment and/or annual household income are inversely associated with cardiovascular risk in a sample of Deaf ASL users. Methods: The Deaf Health Survey (DHS) is an adapted and translated Behavioral Risk Factor Surveillance System (BRFSS) into sign language. A sample of 339 Deaf adults from the Rochester, New York MSA participated in the 2008 DHS and is included in the analysis. We assessed education (≤high school [low education], some college, and 4 year college degree or higher [referent]) and annual household income (<$25,000 versus ≥$25,000 [referent]). We constructed an aggregate (i.e. self-report of any of the four cardiovascular disease (CVD) equivalents: diabetes, myocardial infarction (MI), cerebral vascular attack (CVA), and angina) and conducted χ² tests of association for education and income. After excluding for any missing data on key variables, we conducted multi-logistic regression adjusting for : age, sex, race/ethnicity, and smoking. Results: In the study sample, 17.6% had ≤ high school education while 36.1% earned <$25,000; income and education were poorly correlated (r= 0.355). Among this sample (mean age= 46.4, range= 18-88), the prevalence of outcomes was: diabetes (9.4%), MI (5.0%), CVA (0.9%), and angina (4.5%). Unadjusted, low education was significantly associated with reporting an aggregate outcome (χ² =15.6; p=0.0004) whereas income was not (χ² =0.79; p=0.37). Low education continued to be significantly associated with increased likelihood of reporting an aggregate outcome (OR 5.057; 95% CI 1.73-14.82) whereas income was not significantly associated with reporting an aggregate outcome (OR 0.91; 95% CI: 0.39-2.12) even after adjustment. Conclusion: This is the first known study documenting that low educational attainment is associated with higher likelihood of reported cardiovascular disease among Deaf individuals. Higher income did not appear to provide a cardiovascular protective effect, unlike in the general population. This may be partially explained by the poor correlation between educational attainment and income in the study sample. Effective and accessible health communication and education with Deaf individuals with lower educational attainment could be addressed by the use of language-concordant providers and interpreters and following principles of clear communication (e.g. teach-back) to address ongoing cardiovascular health disparities.

Abstract 031: Socioeconomic Trajectories Across the Life Course and Risk of All-cause and Cardiovascular Mortality: Prospective Findings From the Moli-sani Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Marialaura Bonaccio ◽  
Augusto Di Castelnuovo ◽  
Simona Costanzo ◽  
Mariarosaria Persichillo ◽  
Chiara Cerletti ◽  
...  
Keyword(s):  
General Population ◽  
Educational Attainment ◽  
Life Course ◽  
Lower Risk ◽  
Cox Regression ◽  
Low Ses ◽  
Increased Risk ◽  
Higher Educational ◽  
Higher Educational Attainment ◽  
The Life Course

Introduction: A life course approach has been suggested as the most appropriated to establish the actual impact of socioeconomic status (SES) on health outcomes. Hypothesis: We assessed the hypothesis that SES trajectories from childhood to adulthood are useful to better evaluate the role of SES towards mortality risk in a large general population-based cohort. Methods: Longitudinal analysis on 22,194 subjects recruited in the general population of the Moli-sani study, Italy (2005-2010). Educational attainment (low/high) and SES in adulthood (measured by a score including occupational social class, housing and overcrowding, and dichotomized as low/high) were used to define four possible trajectories both in low and high SES in childhood (age of 8). Hazard ratios (HR) with 95% confidence intervals (95%CI) were calculated by multivariable Cox regression and competing risk models. Results: Over a median follow-up of 8.3 years (182,924 person-years), 1155 all-cause, of which 414 cardiovascular (CVD), deaths were ascertained. In the group with low SES in childhood, as opposed to those stably low (low education and low SES in adulthood), an upward in both educational attainment and material factors in adulthood was associated with lower risk of both all-cause (HR=0.64; 95%CI 0.52-0.79; Table) and CVD mortality (HR=0.62; 0.43-0.88), respectively. Subjects with high childhood SES experienced an increased risk of total and CVD death in absence of higher educational attainment despite a higher SES in adulthood (HR=1.47; 1.04-2.07 and HR=1.75;1.00-3.05, respectively) as compared to the group with both high education and high SES in adulthood. Conclusions: In conclusion, for individuals with low SES in childhood, an upward of both educational attainment and material factors over the life course is associated with lower risk of total and CVD death. In advantaged groups in childhood, lack of a higher educational attainment, rather than material factors, over the life course appears to be unfavourably associated with survival.

scholarly journals Trends and Disparities in Self-Reported and Measured Osteoporosis among US Adults, 2007–2014

2019 ◽  
Vol 8 (12) ◽  
pp. 2052 ◽  
Author(s):  
Qing Wu ◽  
Yingke Xu ◽  
Ge Lin
Keyword(s):  
High School ◽  
Socioeconomic Status ◽  
Educational Attainment ◽  
National Health ◽  
Family Income ◽  
Education Attainment ◽  
The Us ◽  
Race Ethnicity ◽  
Higher Educational Attainment ◽  
Nutritional Examination Survey

(1) Background: Studies examining osteoporosis trends among US adults by different socioeconomic status (SES) are limited. The prevalence of self-reported osteoporosis in the US is rarely reported. (2) Methods: Data from the National Health and Nutritional Examination Survey (NHANES) between 2007–2008 and 2013–2014 cycles were analyzed. Age-adjusted prevalence of self-reported and that of measured osteoporosis were calculated overall and by sex, race/ethnicity, education attainment, and SES. (3) Results: The prevalence of self-reported osteoporosis was higher than that of measured osteoporosis in all three survey cycles for women, and in 2007–2008 and 2009–2010 for men. Participants with high school/GED or higher educational attainment had an increased prevalence of measured osteoporosis during the study period. Among all SES groups, participants with low family income (PIR < 1.3) had the highest prevalence of measured osteoporosis, and the prevalence increased from 49.3 per 1000 population to 71.8 per 1000 population during the study period. (4) Conclusions: The prevalence of self-reported osteoporosis was higher than that of measured osteoporosis in US adults between 2007 and 2014. The age-adjusted prevalence of measured osteoporosis increased in participants with the educational attainment of high school/GED or above, and individuals with low family income.

scholarly journals Practical ways to deal with the high burden of cardiovascular disease in hemodialysis patients

2006 ◽  
Vol 124 (1) ◽  
pp. 36-41 ◽  
Author(s):  
José Jayme Galvão de Lima
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
General Population ◽  
Cardiovascular Risk Factors ◽  
Ventricular Hypertrophy ◽  
Significant Proportion ◽  
Hemodialysis Patients ◽  
Left Ventricular ◽  
Dialysis Patients

Cardiovascular disease is the main cause of death among hemodialysis patients. Although uremia by itself may be considered to be a cardiovascular risk factor, a significant proportion of dialysis patients die because of cardiovascular disease not directly attributable to uremia. Indeed, many of the cardiovascular diseases and cardiovascular risk factors in these patients are common to those occurring in the general population and are amenable to intervention. Lack of proper medical care during the early stages of renal insufficiency and present-day dialysis routines, by failing to correct hypertension, hypervolemia and left ventricular hypertrophy in many patients, may also add to the cardiovascular burden. The author suggests that, in addition to early treatment and referral to a specialist, chronic renal failure patients should undergo intensive cardiovascular screening and treatment, and correction of cardiovascular risk factors based on guidelines established for the general population.

scholarly journals Educational inequalities in statin treatment for preventing cardiovascular disease: cross-sectional analysis of UK Biobank

2020 ◽  
Author(s):  
Alice R Carter ◽  
Dipender Gill ◽  
Richard Morris ◽  
George Davey Smith ◽  
Amy E Taylor ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Primary Care ◽  
Cardiovascular Risk ◽  
Educational Attainment ◽  
Prescription Data ◽  
List Type ◽  
Uk Biobank ◽  
Cross Sectional ◽  
Statin Use ◽  
Years Of Schooling

AbstractImportanceThe most socioeconomically deprived individuals remain at the greatest risk of cardiovascular disease. Differences in risk adjusted use of statins between educational groups may contribute to these inequalities.ObjectiveTo identify whether people with lower levels of educational attainment are less likely to take statins for a given level of cardiovascular risk.DesignCross-sectional analysis of a population-based cohort study and linked longitudinal primary care records.SettingUK Biobank data from baseline assessment centres, linked primary care data and hospital episode statisticsParticipantsUK Biobank participants (N = 489 679, mean age = 56, 54% female) with complete data on educational attainment and self-reported medication use. Secondary analyses were carried out on a subsample of participants with linked primary care data (N = 217 675).Main outcome measuresStatin use self-reported to clinic nurses at baseline assessment centres, validated with linked prescription data in a subsample of participants in secondary analyses.ResultsGreater education was associated with lower statin use, whilst higher cardiovascular risk (assessed by QRISK3 score) was associated with higher statin use in both females and males. There was evidence of an interaction between QRISK3 and education, such that for the same QRISK3 score, people with more education were more likely to report taking statins. For example, in women with 7 years of schooling, equivalent to leaving school with no formal qualifications, a one unit increase in QRISK3 score was associated with a 6% higher odds of statin use (odds ratio (OR) 1.06, 95% CI 1.05, 1.06). In contrast, in women with 20 years of schooling, equivalent to obtaining a degree, a one unit increase in QRISK3 score was associated with an 11% higher odds of statin use (OR 1.11, 95% CI 1.10, 1.11). Comparable ORs in men were 1.04 (95% CI 1.04, 1.05) for men with 7 years of schooling and (95% CI 1.07, 1.07) for men with 20 years of schooling.ConclusionsFor the same level of cardiovascular risk, individuals with lower educational attainment are less likely to receive statins, likely contributing to health inequalities.SummaryWhat is already known on this topic?Despite reductions in the rates of cardiovascular disease in high income countries, individuals who are the most socioeconomically deprived remain at the highest risk.Although intermediate lifestyle and behavioural risk factors explain some of this, much of the effect remains unexplained.What does this study add?For the same increase in QRISK3 score, the likelihood of statin use increased more in individuals with high educational attainment compared with individuals with lower educational attainment.These results were similar when using UK Biobank to derive QRISK3 scores and when using QRISK scores recorded in primary care records, and when using self-reported statin prescription data or prescription data from linked primary care records.The mechanisms leading to these differences are unknown, but both health seeking behaviours and clinical factors may contribute.

Abstract 3758: High Pulse Wave Velocity has a Strong Impact on Early Carotid Atherosclerosis in a Japanese General Population

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Takuro Kubozono ◽  
Masaaki Miyata ◽  
Shuichi Hamasaki ◽  
Kazuto Saito ◽  
Ken Kusano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
General Population ◽  
Carotid Atherosclerosis ◽  
Pulse Wave ◽  
Fasting Glucose ◽  
Density Lipoprotein ◽  
Carotid Imt ◽  
Japanese General Population

Background : Pathological changes in large arteries make an important contribution to the pathogenesis of cardiovascular disease. The etiology and progression of such changes involve both structural and functional components. Intima-media thickness (IMT) of carotid artery has been reported to be associated with cardiovascular mortality and morbidity. Pulse wave velocity (PWV), which reflects functional arterial stiffness, is reported to be a prognostic predictor of cardiovascular disease. The purpose of this study is to investigate the association between carotid IMT and cardiovascular risk factors in a Japanese general population. Methods : The study group consisted of 1843 subjects (1583 men, 260 women, mean age: 57±10 years) undergoing routine health checkups. IMT of common carotid artery was measured with high-resolution ultrasonography. Brachial-ankle (baPWV) and blood pressure (BP) was measured using automated device. Obesity was shown by body mass index ≥ 25.0 kg/m2. Hypertension was defined as systolic BP (SBP) ≥130 mmHg or diastolic BP (DBP) ≥ 85 mmHg. Dyslipidemia was identified by low density lipoprotein cholesterol (LDL) concentration ≥ 140mg/dl, triglyceride (TG) ≥ 150 mg/dl, or high density lipoprotein cholesterol (HDL) ≥ 40 mg/dl. Impaired fasting glucose (IFG) was defined as fasting glucose ≥ 110 gm/dl. Results : Univariate analysis demonstrated that carotid IMT significantly associated with age, BMI, SBP, DBP, baPWV, fasting glucose, LDL, TG, and HDL. Multiple logistic regression analysis for carotid atherosclerosis (carotid IMT ≥ 1.0 mm) was performed using obesity, hypertension, dyslipidemia, IFG, and high baPWV (≥ 400 cm/sec). After adjustment for age and gender, carotid atherosclerosis was significantly associated with high baPWV (OR: 2.256, 95% CI: 1.244 – 4.093, P < 0.01) and hypertension (OR: 1.543, 95% CI: 1.009 –2.361, P < 0.05). Conclusion : Carotid IMT correlated with conventional cardiovascular risk factors. Furthermore, high PWV was a stronger predictor of early carotid atherosclerosis rather than hypertension, dyslipidemia, and IFG in a Japanese general population.

scholarly journals Socioeconomic status and risk of kidney dysfunction: the Atherosclerosis Risk in Communities study

2018 ◽  
Vol 34 (8) ◽  
pp. 1361-1368 ◽  
Author(s):  
Priya Vart ◽  
Morgan E Grams ◽  
Shoshana H Ballew ◽  
Mark Woodward ◽  
Josef Coresh ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Educational Attainment ◽  
Low Income ◽  
Household Income ◽  
Income Group ◽  
Annual Household Income ◽  
Neighborhood Deprivation ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Egfr Decline

Abstract Background There is strong evidence of an association between socioeconomic status (SES) and end-stage renal disease (ESRD). However, the association of SES with the risk of chronic kidney disease (CKD) and the rate of change in kidney function is unclear. Methods A cohort of 14 086 participants with an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 at baseline in the Atherosclerosis Risk in Communities study (1987–89) were studied. The association of annual household income, educational attainment and neighborhood deprivation with incident ESRD, incident CKD and change in eGFR using four measurements over ∼23 years was assessed. Results A total of 432 participants developed ESRD and 3510 developed CKD over a median follow-up time of ∼23 years. After adjustment for demographics and baseline eGFR, the hazard ratio (HR) for incident ESRD compared with the high-income group was 1.56 [95% confidence interval (CI) 1.22–1.99 in the medium-income group and 2.30 (95% CI 1.75–3.02) in the low-income group (P-trend < 0.001), and for CKD was 1.10 (95% CI 1.01–1.20) in the medium-income group and 1.30 (95% CI 1.17–1.44) in the low-income group (P-trend < 0.001). After full adjustments, the HR for ESRD was 1.33 (95% CI 1.03–1.70) in the medium-income group and 1.50 (95% CI 1.14–1.98) in the low-income group (P-trend = 0.003) and for CKD was 1.01 (95% CI 0.92–1.10) in the medium-income group and 1.04 (95% CI 0.93–1.16) in the low-income group (P-trend = 0.50). The eGFR decline was 5% and 15% steeper in the medium- and low-income groups, respectively, after full adjustment (P-trend < 0.001). Results were similar, with lower educational attainment and higher neighborhood deprivation being associated with adverse outcomes. Conclusions SES (annual household income, educational attainment or neighborhood deprivation) was associated not only with ESRD risk but also with eGFR decline, although the association with CKD appeared weaker.

scholarly journals Diminished Returns of Educational Attainment on Heart Disease among Black Americans

2020 ◽  
Vol 14 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Shervin Assari ◽  
Sharon Cobb ◽  
Mohammed Saqib ◽  
Mohsen Bazargan
Keyword(s):  
High School ◽  
Heart Disease ◽  
Educational Attainment ◽  
Race And Ethnicity ◽  
Black People ◽  
Hispanic Americans ◽  
Future Research ◽  
Behavioral Risk ◽  
Nationally Representative ◽  
Higher Educational Attainment

Background: Socioeconomic Status (SES) indicators, such as educational attainment, are social determinants of heart disease. Marginalization related Diminished Returns (MDRs) refer to smaller health benefits of high SES for racial and ethnic minorities compared to the majority group. It is still unknown, however, if MDRs also apply to the effects of education on heart disease. Purpose: Using a nationally representative sample, we explored racial/ethnic variation in the link between educational attainment and heart disease among American adults. Methods: We analyzed data (n=25,659) from a nationally representative survey of American adults in 2013. The first wave of the Population Assessment of Tobacco and Health - Adult (PATH-Adult) study was used. The independent variable was education (college graduate, high school graduate, less than a high school diploma). The dependent variable was any heart disease. Age and gender were the covariates. Race, as well as ethnicity, were the moderators. Logistic regressions were used to analyze the data. Results: Individuals with higher educational attainment had lower odds of heart disease. Race and ethnicity showed statistically significant interactions with education, suggesting that the protective effect of higher education on reducing odds of heart disease was smaller for Hispanic and Black people than for non-Hispanic and White individuals. Conclusion: Education reduces the risk of heart disease better among non-Hispanic Whites than for Hispanics and Blacks. Therefore, we may expect a disproportionately higher than expected risk of heart disease in Hispanics and Blacks with high educational attainment. Future research should test if the presence of high levels of environmental and behavioral risk factors contribute to the high risk of heart disease in highly educated Black and Hispanic Americans. Policymakers should not reduce health inequalities to just gaps in SES because disparities are present across SES levels, with high SES Blacks and Hispanics remaining at risk of health problems.

scholarly journals Distribution of Cardiovascular Risk Factors in Patients with Psoriasis

2019 ◽  
Vol 70 (5) ◽  
pp. 1643-1648
Author(s):  
Ana Maria Alexandra Stanescu ◽  
Ioana Veronica Grajdeanu ◽  
Bogdan Serban ◽  
Camelia Cristina Diaconu
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
General Population ◽  
Cardiovascular Risk Factors ◽  
Family Doctor ◽  
Family Doctors ◽  
Cardiovascular Comorbidities ◽  
Increased Risk ◽  
Systemic Disorder

Psoriasis is a chronic inflammatory systemic disorder that associates many cardiovascular comorbidities. The association between psoriasis and cardiovascular disease is a complex one, which implies many risk factors, such as age, gender, heredity, smoking, alcohol and stress. The prognosis of patients with psoriasis may be improved by identifying and reduction of these cardiovascular risk factors. The objective of our study was to determine the prevalence of cardiovascular risk factors among patients with psoriasis from Bucharest and Ilfov county, Romania. 634 individuals from the general population were initially included. From these individuals, 208 patients with psoriasis have been selected for inclusion in our observational study. The patients were selected from Elias Emergency Hospital of Bucharest, Romania, and through the family doctors praxis, between 2010-2017. Of the 634 individuals from the general population, 208 patients (33%) were identified as patients with a diagnosis of vulgar psoriasis, confirmed by the dermatologist, forming the study group. The presence of risk factors is consistent with the presence of cardiovascular disease (23%) in the studied group. Patients with psoriasis, without cardiovascular diseases, have an increased risk of developing them throughout their lives. Patients with psoriasis have a very high risk of developing life-long cardiovascular disease, because of a multitude of risk factors associated with psoriasis. Intervention on modifiable risk factors for cardiovascular disease can be mediated by a family doctor, who can monitor the development over time and may also intervene early when appropriate.

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