Relation of socioeconomic position with ankle-brachial index.
Pubmed ID: 21907950
Pubmed Central ID: PMC3575172
Journal: The American journal of cardiology
Publication Date: 12/01/2011
Affiliation: Department of Epidemiology, Brown University, Providence, Rhode Island, USA. Golareh_agha@brown.edu
MeSH Terms: Humans, Male, Adult, Female, United States, Middle Aged, Coronary Disease, Blood Pressure, Social Class, Prognosis, Follow-Up Studies, Morbidity, Survival Rate, Retrospective Studies, Socioeconomic Factors, Ankle Brachial Index, Atherosclerosis, Europe
Grants: MOP81239, N01 HC025195, N01-HC-25195, N01HC25195, HOA80072
Authors: Loucks EB, Abrahamowicz M, Lynch JW, Murabito JM, Agha G, Harper SB
Cite As: Agha G, Murabito JM, Lynch JW, Abrahamowicz M, Harper SB, Loucks EB. Relation of socioeconomic position with ankle-brachial index. Am J Cardiol 2011 Dec 1;108(11):1651-7. Epub 2011 Sep 10.
Potential upstream determinants of coronary heart disease (CHD) include life-course socioeconomic position (e.g., childhood socioeconomic circumstances, own education and occupation); however, several plausible biological mechanisms by which socioeconomic position (SEP) may influence CHD are poorly understood. Several CHD risk factors appear to be more strongly associated with SEP in women than in men; little is known as to whether any CHD risk factors may be more strongly associated with SEP in men. Objectives were to evaluate whether cumulative life-course SEP is associated with a measurement of subclinical atherosclerosis, the ankle-brachial index (ABI), in men and women. This study was a prospective analysis of 1,454 participants from the Framingham Heart Study Offspring Cohort (mean age 57 years, 53.8% women). Cumulative SEP was calculated by summing tertile scores for father's education, own education, and own occupation. ABI was dichotomized as low (≤1.1) and normal (>1.1 to 1.4). After adjustment for age and CHD risk factors cumulative life-course SEP was associated with low ABI in men (odds ratio [OR] 2.04, 95% confidence interval [CI] 1.22 to 3.42, for low vs high cumulative SEP score) but not in women (OR 0.86, 95% CI 0.56 to 1.33). Associations with low ABI in men were substantially driven by their own education (OR 4.13, 95% CI 1.86 to 9.16, for lower vs higher than high school education). In conclusion, cumulative life-course SEP was associated with low ABI in men but not in women.