Socioeconomic Status and Risk of Acute Myocardial Infarction. Population-Based Case-Control Study (original) (raw)
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American Journal of Epidemiology, 1996
Much remains to be understood about how low socioeconomic status (SES) increases cardiovascular disease and mortality risk. Data from the Kuopio Ischemic Heart Disease Risk Factor Study (1984)(1985)(1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993) were used to estimate the associations between acute myocardial infarction and income, all-cause mortality, and cardiovascular mortality in a population-based sample of 2,272 Finnish men, with adjustment for 23 biologic, behavioral, psychologic, and social risk factors. Compared with the highest income quintile, those in the bottom quintile had age-adjusted relative hazards of 3.14 (95% confidence interval (Cl) 1.77-5.56), 2.66 (95% Cl 1.25-5.66), and 4.34 (95% Cl 1.95-9.66) for all-cause mortality, cardiovascular mortality, and AMI, respectively. After adjustment for risk factors, the relative hazards for the same comparisons were 1.32 (95% Cl 0.70-2.49), 0.70 (95% Cl 0.29-1.69), and 2.83 (95% Cl 1.14-7.00). In the lowest income quintile, adjustment for risk factors reduced the excess relative risk of all-cause mortality by 85%, that of cardiovascular mortality by 118%, and that of acute myocardial infarction by 45%. These data show how the association between SES and cardiovascular mortality and all-cause mortality is mediated by known risk factor pathways, but full "explanations" for these associations will need to encompass why these biologic, behavioral, psychologic, and social risk factors are differentially distributed by SES. Am J Epidemiol 1996;144:934-42.
Socioeconomic Status and Coronary Heart Disease
2011
Background: Iran has undergone a remarkable demographic transition over the last three decades. Socioeconomic status (SES) indicators including education, income, and occupation are associated with coronary heart disease (CHD) risk factors, morbidity, and mortality. The aim of the present study was to describe demographic and socioeconomic characteristics, their association to the diseases, and to explore the predictive risk of CHD in Tabriz, the fourth largest city in Iran and the capital of East Azerbaijan Province. Methods: This cross-sectional descriptive study was carried out to explore and analyze the current SES status of CHD patients. The study was conducted in Tabriz and all patients (n=189) refereed to the Central Referral Hospital for cardiac patients (Shahid Madani Hospi-tal) from 2009 to 2010 were considered. A researcher structured questionnaire with 15 ques-tions was used to collect data. Descriptive statistics were used to describe the basic SES fea-tures of the CHD ...
Life-Course Socioeconomic Position and Incidence of Coronary Heart Disease
American Journal of Epidemiology, 2009
Cumulative exposure to socioeconomic disadvantage across the life course may be inversely associated with coronary heart disease (CHD); the mechanisms are not fully clear. An objective of this study was to determine whether cumulative life-course socioeconomic position (SEP) is associated with CHD incidence in a wellcharacterized US cohort that had directly assessed childhood and adulthood measures of SEP and prospectively measured CHD incidence. Furthermore, analyses aimed to evaluate whether adjustment for CHD risk factors reduces the association between cumulative life-course SEP and CHD. The authors examined 1,835 subjects who participated in the Framingham Heart Study Offspring Cohort from 1971 through 2003 (mean age, 35.0 years; 52.4% women). Childhood SEP was measured as father's education; adulthood SEP was assessed as own education and occupation. CHD incidence included myocardial infarction, coronary insufficiency, and coronary death. Cox proportional hazards analyses indicated that cumulative SEP was associated with incident CHD after adjustment for age and sex (hazard ratio ¼ 1.82, 95% confidence interval: 1.17, 2.85 for low vs. high cumulative SEP score). Adjustment for CHD risk factors reduced that magnitude of association (hazard ratio ¼ 1.29, 95% confidence interval: 0.78, 2.13). These findings underscore the potential importance of CHD prevention and treatment efforts for those whose backgrounds include low SEP throughout life.
BMJ open, 2014
Cardiovascular health (CVH) is a relatively new concept defined by the American Heart Association (AHA). The aim of the present study was to assess whether the indices of CVH were discriminators of socioeconomic status (SES) in the adult population of the Republic of Srpska (RS). Population-based cross-sectional study. RS, Bosnia and Herzegovina. The study involved 4165 adults aged ≥18 years (mean age 50.2; 54% women) who participated in the National Health Survey performed from September to November 2010 in the RS. Participant's education was a proxy for SES. Potential discriminators of SES were indices of CVH presented according to AHA as: ideal health behaviours index (non-smoking, body mass index <25 kg/m(2), physical activity at goal level and healthy diet); ideal health factors index (untreated total cholesterol <200 mg/dL, untreated blood pressure <120/<80 mm Hg, untreated fasting glucose <100 mg/dL and non-smoking); and ideal CVH status (defined as all sev...
Cardiovascular disease and socioeconomic status
Supplement to CMAJ 2000;162(9 Suppl) Cardiovascular disease risk factors CMAJ • 2 MAY 2000; 162 (9 Suppl) S3 © Her Majesty the Queen in right of Canada 2000 as represented by the Minister of Health Cardiovascular disease and socioeconomic status Bruce P. Squires B etween 1982 and 1992, the Canadian provincial heart health surveys were conducted as part of the Canadian Heart Health Initiative, a collaborative program of the provincial departments of health and Health Canada (then the Department of National Health and Welfare) to provide a database for planning and evaluating demonstration programs to prevent cardiovascular disease (CVD). In this CMAJ supplement, Potvin and co-authors (page S5) and Choinière and colleagues (page S13) report the results of analyses conducted to determine the relationship between socioeconomic factors (education, income level and occupation) and the prevalence of risk factors for CVD and the public's ability to identify those risk factors (fat in food, smoking, lack of exercise, excess weight, elevated blood cholesterol and high blood pressure).
Early-life and adult socioeconomic determinants of myocardial infarction incidence and fatality
Social science & medicine (1982), 2017
Social inequalities in coronary heart disease mortality have roots in childhood conditions, but it is unknown whether they are associated both with the incidence of the disease and the following survival. We studied how several different early-life socioeconomic factors, together with later socioeconomic attainment, were associated with myocardial infarction (MI) incidence and fatality in Finland. The data was based on a register-based sample of households from a census in 1950 that also provided information on childhood circumstances. MI hospitalizations and mortality in 1988-2010 were studied in those who were up to 14 years of age at the time of the census and resident in Finland in 1987 (n = 94,501). Parental education, occupation, household crowding, home ownership, and family type were examined together with adulthood education and income. Hazard and odds ratios with 95% confidence intervals (CI) were calculated using Cox regression (incidence and long-term fatality) and logis...
Social Determinants of Myocardial Infarction Risk and Survival: A Systematic Review
European Journal of Cardiovascular Research, 2020
Social determinants of health that have been examined in relation to myocardial infarction incidence and survival include socioeconomic status (income, education), neighbourhood disadvantage, immigration status, social support, and social network. Other social determinants of health include geographic factors such as neighbourhood access to health services. Socioeconomic factors influence risk of myocardial infarction. Myocardial infarction incidence rates tend to be inversely associated with socioeconomic status. In addition, studies have shown that low socioeconomic status is associated with increased risk of poorer survival. There are well-documented disparities in myocardial infarction survival by socioeconomic status, race, education, and census-tract-level poverty. The results of this review indicate that social determinants such as neighbourhood disadvantage, immigration status, lack of social support, and social isolation also play an important role in myocardial infarction ...