Much remains to be understood about how low socioeconomic status (SES) increases cardiovascular disease and mortality risk.
Data from the Kuopio Ischemic Heart Disease Risk Factor Study (1984-1993) were used to estimate the associations between acute myocardial infarction and income, all-cause mortality, and cardiovascular mortality in a population-based sample of 2,272 Finnish men, with adjustment for 23 biologic, behavioral, psychologic, and social risk factors.
Compared with the highest income quintile, those in the bottom quintile had age-adjusted relative hazards of 3.14 (95% confidence interval (CI) 1.77-5.56), 2.66 (95% Cl 1.25-5.66), and 4.34 (95% Cl 1.95-9.66) for all-cause mortality, cardiovascular mortality, and AMI, respectively.
After adjustment for risk factors, the relative hazards for the same comparisons were 1.32 (95% CI 0.70-2.49), 0.70 (95% CI 0.29-1.69), and 2.83 (95% CI 1.14-7.00).
In the lowest income quintile, adjustment for risk factors reduced the excess relative risk of all-cause mortality by 85%, that of cardiovascular mortality by 118%, and that of acute myocardial infarction by 45%. These data show how the association between SES and cardiovascular mortality and all-cause mortality is mediated by known risk factor pathways, but full « explanations » for these associations will need to encompass why these biologic, behavioral, psychologic, and social risk factors are differentially distributed by SES.
Mots-clés Pascal : Appareil circulatoire pathologie, Infarctus, Myocarde, Mortalité, Statut socioéconomique, Facteur risque, Epidémiologie, Homme, Finlande, Europe, Cardiopathie coronaire, Myocarde pathologie
Mots-clés Pascal anglais : Cardiovascular disease, Infarct, Myocardium, Mortality, Socioeconomic status, Risk factor, Epidemiology, Human, Finland, Europe, Coronary heart disease, Myocardial disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0032134
Code Inist : 002B12A03. Création : 21/05/1997.