Socioeconomic position in childhood and adult cardiovascular risk factors, vascular structure, and function: cardiovascular risk in young Finns study (original) (raw)
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Hypertension, 2005
Studies have found an association between low socioeconomic position in childhood and high adult blood pressure. It is unclear whether this association is explained by a pathway directly linking disadvantage to elevated blood pressure in childhood and adolescence, which then tracks into adulthood. We assessed parental socioeconomic position and systolic blood pressure in 1807 children and adolescents ages 3 to 18 years at baseline. Adult systolic blood pressure was measured 21 years later at ages 24 to 39 years. There was strong tracking of blood pressure from childhood to adulthood. Lower parental socioeconomic position was associated with higher blood pressure in childhood, adolescence (PϽ0.01), and adulthood (PϽ0.0001), with the mean age-and sex-adjusted systolic pressure differences between the highest and lowest socioeconomic groups varying between 2.9 and 4.3 mm Hg. With adjustment for blood pressure in childhood and adolescence, the regression coefficient between parental socioeconomic position and adult blood pressure attenuated by 32%. A similar level of attenuation (28%) occurred with adjustment for adult body mass index (BMI). With adjustment for both preadult blood pressure and adult BMI, the association between parental socioeconomic position and adult blood pressure was attenuated by 45%. Other factors, including birth weight and BMI in childhood and adolescence, had little impact on the association between parental socioeconomic position and adult blood pressure. These data suggest that early socioeconomic disadvantage influences later blood pressure in part through an effect on blood pressure in early life, which tracks into adulthood, and in part through an effect on BMI. (Hypertension. 2006; 47:39-44.)
Annals of Epidemiology, 2006
Prospective evidence suggests an inverse association between socioeconomic circumstances in childhood and adolescence and blood pressure (BP) in adulthood, but uncertainty remains about whether this association is confounded by risk factors acting in utero, early infancy, and adulthood. The authors investigated this question in a population-based cohort of 2270 Finnish children and adolescents aged 3 to 18 years at study entry. Information about early socioeconomic circumstances, birth weight, and breast-feeding were requested from participants or their mothers in 1980 and 1983. Adulthood socioeconomic position, lifestyle factors, and systolic BP were measured at ages 24 to 39 years in 2001. There was a graded association between lower parental socioeconomic position in childhood and adolescence and higher systolic BP in adulthood for men and women in different birth cohorts and across different socioeconomic indicators. This association was independent of adulthood socioeconomic position. Adjustment for risk factors, including birth weight, breast-feeding, adult body mass index, smoking, and alcohol consumption, had little effect on the association between parental socioeconomic position and systolic BP. Early socioeconomic disadvantage seems to carry a long-lasting harmful effect on BP that is not counteracted by risk profiles in later life.
Arteriosclerosis, Thrombosis, and Vascular Biology, 2012
Objective-The goal of this study was to investigate the extent to which socioeconomic status (SES) in young adults is associated with cardiovascular risk factor levels and carotid intima-media thickness (IMT) and their changes over a 6-year follow-up period. Methods and Results-The study population included 1813 subjects participating in the 21-and 27-year follow-ups of the Cardiovascular Risk in Young Finns Study (baseline age 24 -39 years in 2001). At baseline, SES (indexed with education) was inversely associated with body mass index (Pϭ0.0002), waist circumference (PϽ0.0001), glucose (Pϭ0.01), and insulin (Pϭ0.0009) concentrations; inversely associated with alcohol consumption (Pϭ0.02) and cigarette smoking (PϽ0.0001); and directly associated with high-density lipoprotein cholesterol levels (Pϭ0.05) and physical activity (Pϭ0.006). Higher SES was associated with a smaller 6-year increase in body mass index (Pϭ0.001). Education level and IMT were not associated (Pϭ0.58) at baseline, but an inverse association was observed at follow-up among men (Pϭ0.004). This became nonsignificant after adjustment with conventional risk factors (Pϭ0.11). In all subjects, higher education was associated with a smaller increase in IMT during the follow-up (Pϭ0.002), and this association remained after adjustments for conventional risk factors (Pϭ0.04).
Cardiovascular risks and socioeconomic status: differences between men and women in Finland
Journal of Epidemiology and Community Health, 1994
Study objective -The study aimed to assess the association of different indicators of socioeconomic status with levels of cardiovascular disease risk factors in men and women aged 25-64 years. Design -This was a cross sectional survey, using a community based random sample. Setting -The provinces of North Karelia and Kuopio in eastern Finland and the cities of Turku and Loimaa and surrounding communities in southwestern Finland in 1987. Participants -Altogether 2164 men and 2182 women aged 25-64 years took part. Measurements and main results -Data were collected using self administered questionnaires and the measurement of height, body weight, and blood pressure and blood sampling for lipid determinations were done at the survey site. The risk of cardiovascular disease was determined by calculating a simple risk factor score based on the observed values of HDL and total cholesterol, leisure time, physical activity, blood pressure, medication for hypertension, body mass index, and smoking. Indicators of socioeconomic position used were years of education, family income, marital status, and the person's occupation. Lower levels of education, occupation, and income were all significantly associated with an unfavorable risk factor profile in men and women. Education and occupation showed the strongest associations with the risk factor score in both men and women. The results changed little when adjusting for income and marital status. Family income was more strongly associated with the risk factor score in women than men. When adjusting for occupation and education, income was no longer sig-
Childhood Socioeconomic Position and Adult Cardiovascular Mortality: The Boyd Orr Cohort
American Journal of Epidemiology, 1999
The relation between childhood socioeconomic position and adult cardiovascular mortality is examined in 3,750 individuals whose families took part in the Carnegie survey of family diet and health in England and Scotland between 1937 and 1939. The trend in coronary heart disease mortality across social position groups was not statistically significant at conventional levels (p = 0.12), while a strong linear trend was seen for stroke mortality (p = 0.01). Adjustment for the Townsend deprivation index of area of residence during adult life did not materially alter these findings, indicating that the effects of socioeconomic influences upon particular cardiovascular diseases differ according to the age at which they are experienced.
BMC Public Health, 2012
Background: The mechanisms underlying socioeconomic inequalities in mortality from cardiovascular diseases (CVD) are largely unknown. We studied the contribution of childhood socioeconomic conditions and adulthood risk factors to inequalities in CVD mortality in adulthood. Methods: The prospective GLOBE study was carried out in the Netherlands, with baseline data from 1991, and linked with the cause of death register in 2007. At baseline, participants reported on adulthood socioeconomic position (SEP) (own educational level), childhood socioeconomic conditions (occupational level of respondent's father), and a broad range of adulthood risk factors (health behaviours, material circumstances, psychosocial factors). This present study is based on 5,395 men and 6,306 women, and the data were analysed using Cox regression models and hazard ratios (HR). Results: A low adulthood SEP was associated with increased CVD mortality for men (HR 1.84; 95% CI: 1.41-2.39) and women (HR 1.80; 95%CI: 1.04-3.10). Those with poorer childhood socioeconomic conditions were more likely to die from CVD in adulthood, but this reached statistical significance only among men with the poorest childhood socioeconomic circumstances. About half of the investigated adulthood risk factors showed significant associations with CVD mortality among both men and women, namely renting a house, experiencing financial problems, smoking, physical activity and marital status. Alcohol consumption and BMI showed a U-shaped relationship with CVD mortality among women, with the risk being significantly greater for both abstainers and heavy drinkers, and among women who were underweight or obese. Among men, being single or divorced and using sleep/anxiety drugs increased the risk of CVD mortality. In explanatory models, the largest contributor to adulthood CVD inequalities were material conditions for men (42%; 95% CI: −73 to −20) and behavioural factors for women (55%; 95% CI: -191 to −28). Simultaneous adjustment for adulthood risk factors and childhood socioeconomic conditions attenuated the HR for the lowest adulthood SEP to 1.34 (95% CI: 0.99-1.82) for men and 1.19 (95% CI: 0.65-2.15) for women.
European Journal of Cardiovascular Prevention & Rehabilitation, 2005
Background Social status has been related with the prevalence and incidence of cardiovascular disease. The aim of this study is to investigate the relationships between socioeconomic status (SES) and clinical and biochemical factors related to coronary heart disease, in a sample of cardiovascular disease-free men and women. Design Cross-sectional survey. Methods During 2001-2002, 1514 men (20-87 years old) and 1528 women (20-89 years old) from the Attica region (Greece) were randomly enrolled into the study. Trends in established and emerging cardiovascular risk factors were examined across the participants' socioeconomic status. A special index was developed (years of school by annual income) and three socioeconomic classes were created. Results An inverse relationship was found regarding all lipids and glucose levels across the tertiles of the SES index. An inverse association was observed between body mass index, waist-to-hip ratio and SES in men, but not in women. Furthermore, compared to the lowest tertile, individuals who were classified in the highest SES tertile had lower levels of C-reactive protein, fibrinogen, homocysteine, tumour necrosis factor-a, interleukin-6 levels and white blood cell counts, even after adjusting for various potential confounders. Finally,a considerable proportion of men and women reported lack of health knowledge and education. Conclusions An inverse association between SES and factors related.to cardiovascular risk exists, but the causal pathway itself requires more detailed explanation before the social status can have explanatory power.
Social Science & Medicine, 1985
In this study, the hypothesis that bad socio-economic conditions in childhood may increase the probability of coronary heart disease in adulthood is examined. The study is based partly on the data of the East-West Study in Finland, which is part of the Seven Countries Study. The study began with 823 men in Eastern Finland and 888 men in Western Finland in 1959. The mortality and morbidity of the cohorts were followed from 1959 to 1974. Risk factors were measured in medical examinations in 1959, 1964, 1969 and 1974. Parents of those included in the sample were traced by using parish registers from 1900 to 1919. Over 90% of those in the East-West Study were found. The parents' socio-economic position (socioeconomic conditions in childhood) was determined. According to our findings, the relative risks of coronary death, myocardial infarction and ischemic heart disease are systematically increased for those born landless in East Finland. Variables partly explaining the increased risk were body height and smoking. The effect of cholesterol was negligible.