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Cited by 262Health disparities and outcomesCardiovascular Health and Risk FactorsLipoproteins and Cardiovascular Health

The DOI matches its Crossref record; 32 of the 33 references it cites were found in a registry or an index.

Impact of Traditional and Novel Risk Factors on the Relationship Between Socioeconomic Status and Incident Cardiovascular Events

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Albert, Michelle A., Glynn, Robert J., Buring, Julie, Ridker, Paul M·2006·Circulation
DOI 10.1161/circulationaha.106.660043
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Abstract

Background— Persons of lower socioeconomic status have greater cardiovascular risk than those of higher socioeconomic status. However, the mechanism through which socioeconomic status affects cardiovascular disease (CVD) is uncertain. Virtually no data are available that examine the prospective association between novel inflammatory and hemostatic CVD risk indicators, socioeconomic status, and incident CVD events. Methods and Results— We assessed the relationship between 2 indicators of socioeconomic status (education and income), traditional and novel CVD risk factors (high sensitivity C-reactive protein, soluble intercellular adhesion molecule-1, fibrinogen, and homocysteine), and incident CVD events among 22 688 apparently healthy female health professionals participating in the Women’s Health Study. These women were followed up for 10 years for the development of myocardial infarction, ischemic stroke, coronary revascularization, and cardiovascular death. More educated women were less likely to be smokers; had a lower prevalence of hypertension, diabetes, and obesity; and were more likely to participate in vigorous physical activity than less educated women. At baseline, median total cholesterol, low-density lipoprotein, triglyceride, C-reactive protein, intercellular adhesion molecule-1, fibrinogen, and homocysteine levels for women in 5 categories of education (<2 years of nursing education, 2 to <4 years of nursing education, a bachelor’s degree, a master’s degree, and a doctoral degree) and 6 categories of income [≤$19 999, $20 000 to $29 999, $30 000 to $39 999, $40 000 to $49 999, $50 000 to $99 999, and ≥$100 000) decreased progressively with increasing education or income levels (all P <0.001), whereas an opposite pattern was observed for high-density lipoprotein ( P <0.001). Overall, in age-adjusted Cox proportional hazards models, the relative risk of incident CVD events decreased with increasing education (1.0, 0.7, 0.5, 0.4, and 0.5; P for trend <0.001) and income (1.0, 1.0, 0.9, 0.7, 0.6, and 0.4; P for trend <0.001) categories. In multivariate models that assessed the impact of traditional and novel CVD risk factors on the relationship between education/income and CVD events, the relative hazard of incident CVD associated with a 1-category-higher level of education changed from 0.79 in age- and race-adjusted analysis to 0.89 in fully adjusted analysis. The 11% lower risk per 1 category of education remained significant ( P for trend=0.006), suggesting that controlling for both novel and traditional risk factors could not explain the protective effect of education. A similar analysis for income revealed that its relationship with CVD events was explained largely by these noted risk factors. Conclusions— In this prospective analysis, we observed a decrease in incident CVD events with increasing levels of education and income. In contrast to the relationship between income and CVD events, the relationship of CVD events with education was explained only partially by traditional and novel risk factors for CVD.

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  1. 10.1161/circ.88.4.8403348 · DOI
  2. 10.1161/atvb.20.7.1842 · DOI
  3. 10.1161/atvb.19.3.485 · DOI
  4. 10.1161/circ.105.9.1135 · DOI

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Metadata

Authors
Albert, M. A., Glynn, R. J., Buring, J., & Ridker, P. M.
Affiliations
Brigham and Women's Hospital (US)
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2006-12-12
Volume
114
Issue
24
Pages
2619-2626
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/circulationaha.106.660043
OpenAlex
W2158868329
Cited by
262
References
33
Citations by year
2026: 5 · 2025: 8 · 2024: 5 · 2023: 8 · 2022: 11 · 2021: 11 · 2020: 4 · 2019: 8 · 2018: 17 · 2017: 23 · 2016: 29 · 2015: 9 · 2014: 12 · 2013: 17 · 2012: 16
FWCI
13.84
Type
journal article
Language
en
Open access
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Robert Wood Johnson Foundation
  • Donald W. Reynolds Foundation
  • National Institutes of Health (5r01hl043851-10)
  • National Heart, Lung, and Blood Institute (R01HL058755, HL43851, HL 63293, HL-58755, R01HL063293)
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
Keywords
socioeconomic status, cardiovascular risk factors, cardiovascular events, income, C-reactive protein, soluble intercellular adhesion molecule-1, fibrinogen, homocysteine, inflammation, hemostasis, women, myocardial infarction, ischemic stroke, cardiovascular mortality, coronary revascularization, Women's Health Study, cardiovascular disease prevention, health disparities, physical activity
MeSH terms
Adult, Aged, C-Reactive Protein, Cardiovascular Diseases, Educational Status, Female, Homocysteine, Humans, Income, Lipids, Male, Middle Aged, Prospective Studies, Risk Factors, Socioeconomic Factors, Proportional Hazards Models

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