Article

Socioeconomic Indicators and the Risk of Acute Coronary Heart Disease Events: Comparison of Population-Based Data from the United States and Finland

University of North Carolina at Chapel Hill, USA.
Annals of epidemiology (Impact Factor: 2.15). 08/2011; 21(8):572-9. DOI: 10.1016/j.annepidem.2011.04.006
Source: PubMed

ABSTRACT We wished to determine whether a gradient of association of low socioeconomic status with incidence of coronary heart disease was present in two population-based cohorts, one from United States and the other from Finland.
Using data from the Atherosclerosis Risk in Communities (ARIC) cohort and the Finnish FINRISK cohort, we estimated, with Cox proportional hazard regression models, incidence of sudden cardiac death (SCD), non-sudden cardiac death (NSCD), and non-fatal myocardial infarction (NFMI) for strata of income and education (follow-up: 1987-2001). In both cohorts, incidence rates of the three outcomes increased across all socioeconomic status exposure categories.
Low education was associated with increased hazard of NFMI in both cohorts and with increased risk of SCD among ARIC women. Low income was significantly associated with increased hazard of all three outcomes among ARIC women and with increased hazard of cardiac death among ARIC men. In FINRISK, low income was significantly associated with increased risk of SCD only. Risk of SCD in the low income categories was similar for both cohorts. Smoking, alcohol consumption, and race (ARIC only) did not appreciably alter effect estimates in either cohort.
Indices of low SES show similar associations with increased risk of cardiac events in Finland and in United States.

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    • "Previous studies have shown that low socioeconomic status of individuals is linked with higher incidences of acute coronary diseases, increased sudden cardiac deaths and higher mortality rates after the first myocardial infarctions.[78] When compared to the individuals in a higher socioeconomic status, this increased risk for cardiovascular events in the lower socioeconomic individuals is not due to the differences in smoking, alcohol consumption or race, but is rather secondary to the lower education levels, less knowledge of cardiovascular diseases and limited access to healthcare resources.[79] "
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