TY - JOUR
T1 - Association of lifelong occupation and educational level with subclinical atherosclerosis in different European regions. Results from the IMPROVE study
AU - IMPROVE Study Grp
AU - Tedesco, Calogero C.
AU - Veglia, Fabrizio
AU - de Faire, Ulf
AU - Kurl, Sudhir
AU - Smit, Andries J.
AU - Rauramaa, Rainer
AU - Giral, Philippe
AU - Amato, Mauro
AU - Bonomi, Alice
AU - Ravani, Alessio
AU - Frigerio, Beatrice
AU - Castelnuovo, Samuela
AU - Sansaro, Daniela
AU - Mannarino, Elmo
AU - Humphries, Steve E.
AU - Hamsten, Anders
AU - Tremoli, Elena
AU - Baldassarre, Damiano
PY - 2018/2
Y1 - 2018/2
N2 - 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 pConclusions: 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. (C) 2017 Published by Elsevier Ireland Ltd.
AB - 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 pConclusions: 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. (C) 2017 Published by Elsevier Ireland Ltd.
KW - Atherosclerosis
KW - Socioeconomic status
KW - European countries
KW - Geographical variations
KW - Vascular risk factors
KW - INTIMA-MEDIA THICKNESS
KW - CORONARY-HEART-DISEASE
KW - SOCIOECONOMIC-STATUS
KW - CARDIOVASCULAR-DISEASE
KW - CAROTID ATHEROSCLEROSIS
KW - MYOCARDIAL-INFARCTION
KW - OLDER-ADULTS
KW - RISK
KW - INEQUALITIES
KW - POPULATION
U2 - 10.1016/j.atherosclerosis.2017.12.023
DO - 10.1016/j.atherosclerosis.2017.12.023
M3 - Article
SN - 0021-9150
VL - 269
SP - 129
EP - 137
JO - Atherosclerosis
JF - Atherosclerosis
ER -