Tedesco, CC;
Veglia, F;
de Faire, U;
Kurl, S;
Smit, AJ;
Rauramaa, R;
Giral, P;
... Baldassarre, D; + view all
(2017)
Association of lifelong occupation and educational level with subclinical atherosclerosis in different European regions. Results from the IMPROVE study.
Atherosclerosis
, 269
pp. 129-137.
10.1016/j.atherosclerosis.2017.12.023.
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Abstract
Background and aims We aimed to examine the association between socioeconomic status (SES) and subclinical atherosclerosis, as assessed by carotid intima-media-thickness (C-IMT) and to investigate whether the effect of social inequality on C-IMT is mediated by cardiovascular (CV) risk factors and whether it is dissimilar in men and women, and in different European countries. Methods We assessed the association of lifelong occupation and educational level with C-IMT in the IMPROVE study cohort including 3703 subjects (median age 64.4 years; 48% men) from Southern (Italy), Western (France and the Netherlands) and Northern Europe (Finland and Sweden). Three summary measures of C-IMT (IMTmean, IMTmax, IMTmean-max), obtained from four segments of both carotids, were considered. Results After adjusting for conventional CV risk factors, current employment status and diet, C-IMT was higher in manual workers than in white collars (+7.7%, +5.3%, +4.6% for IMTmax, IMTmean-max and IMTmean, respectively; all p<.0001). Similar results were obtained by stratification for educational level. The effect of occupation on C-IMT was comparable in men and women and in different age groups, and was only partially mediated by differences in CV risk factors. Of note, the association of C-IMT with occupation was significant in Western and Northern Europe but not in Italy, with a significant statistical interaction (p = .0005). Conclusions Low SES was associated with subclinical atherosclerosis in subjects with at least three CV risk factors. Such association was stronger in Northern and Western Europe than in Italy. This difference was not completely explained by inequalities in CV risk factors and behavioural variables.
| Type: | Article |
|---|---|
| Title: | Association of lifelong occupation and educational level with subclinical atherosclerosis in different European regions. Results from the IMPROVE study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.atherosclerosis.2017.12.023 |
| Publisher version: | https://doi.org/10.1016/j.atherosclerosis.2017.12.... |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Cardiac & Cardiovascular Systems, Peripheral Vascular Disease, Cardiovascular System & Cardiology, Atherosclerosis, Socioeconomic status, European countries, Geographical variations, Vascular risk factors, INTIMA-MEDIA THICKNESS, CORONARY-HEART-DISEASE, SOCIOECONOMIC-STATUS, CARDIOVASCULAR-DISEASE, CAROTID ATHEROSCLEROSIS, MYOCARDIAL-INFARCTION, OLDER-ADULTS, RISK, INEQUALITIES, POPULATION |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10057965 |
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