Socioeconomic status in relation to cardiovascular disease and causespecific mortality: A comparison of Asian and Australasian populations in a pooled analysis

© 2015, BMJ. All rights reserved. Objectives: In Western countries, lower socioeconomic status is associated with a higher risk of cardiovascular disease (CVD) and premature mortality. These associations may plausibly differ in Asian populations, but data are scarce and direct comparisons between th...

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Main Authors: Woodward, M., Peters, S., Batty, G., Ueshima, H., Woo, J., Giles, G., Barzi, F., Ho, S., Huxley, Rachel, Arima, H., Fang, X., Dobson, A., Lam, T., Vathesatogkit, P.
Format: Journal Article
Published: 2015
Online Access:http://hdl.handle.net/20.500.11937/14436
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author Woodward, M.
Peters, S.
Batty, G.
Ueshima, H.
Woo, J.
Giles, G.
Barzi, F.
Ho, S.
Huxley, Rachel
Arima, H.
Fang, X.
Dobson, A.
Lam, T.
Vathesatogkit, P.
author_facet Woodward, M.
Peters, S.
Batty, G.
Ueshima, H.
Woo, J.
Giles, G.
Barzi, F.
Ho, S.
Huxley, Rachel
Arima, H.
Fang, X.
Dobson, A.
Lam, T.
Vathesatogkit, P.
author_sort Woodward, M.
building Curtin Institutional Repository
collection Online Access
description © 2015, BMJ. All rights reserved. Objectives: In Western countries, lower socioeconomic status is associated with a higher risk of cardiovascular disease (CVD) and premature mortality. These associations may plausibly differ in Asian populations, but data are scarce and direct comparisons between the two regions are lacking. We, thus, aimed to compare such associations between Asian and Western populations in a large collaborative study, using the highest level of education attained as our measure of social status. Setting: Cohort studies in general populations conducted in Asia or Australasia. Participants: 303 036 people (71% from Asia) from 24 studies in the Asia Pacific Cohort Studies Collaboration. Studies had to have a prospective cohort study design, have accumulated at least 5000 personyears of follow-up, recorded date of birth (or age), sex and blood pressure at baseline and date of, or age at, death during follow-up. Outcome measures: We used Cox regression models to estimate relationships between educational attainment and CVD (fatal or non-fatal), as well as allcause, cardiovascular and cancer mortality. Results: During more than two million person-years of follow-up, 11 065 deaths (3655 from CVD and 4313 from cancer) and 1809 CVD non-fatal events were recorded. Adjusting for classical CVD risk factors and alcohol drinking, hazard ratios (95% CIs) for primary relative to tertiary education in Asia (Australasia) were 1.81 (1.38, 2.36) (1.10 (0.99, 1.22)) for all-cause mortality, 2.47(1.47, 4.17) (1.24 (1.02, 1.51)) for CVD mortality, 1.66 (1.00, 2.78) (1.01 (0.87, 1.17)) for cancer mortality and 2.09 (1.34, 3.26) (1.23 (1.04, 1.46)) for all CVD. Conclusions: Lower educational attainment is associated with a higher risk of CVD or premature mortality in Asia, to a degree exceeding that in the Western populations of Australasia.
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spelling curtin-20.500.11937-144362017-09-13T14:04:53Z Socioeconomic status in relation to cardiovascular disease and causespecific mortality: A comparison of Asian and Australasian populations in a pooled analysis Woodward, M. Peters, S. Batty, G. Ueshima, H. Woo, J. Giles, G. Barzi, F. Ho, S. Huxley, Rachel Arima, H. Fang, X. Dobson, A. Lam, T. Vathesatogkit, P. © 2015, BMJ. All rights reserved. Objectives: In Western countries, lower socioeconomic status is associated with a higher risk of cardiovascular disease (CVD) and premature mortality. These associations may plausibly differ in Asian populations, but data are scarce and direct comparisons between the two regions are lacking. We, thus, aimed to compare such associations between Asian and Western populations in a large collaborative study, using the highest level of education attained as our measure of social status. Setting: Cohort studies in general populations conducted in Asia or Australasia. Participants: 303 036 people (71% from Asia) from 24 studies in the Asia Pacific Cohort Studies Collaboration. Studies had to have a prospective cohort study design, have accumulated at least 5000 personyears of follow-up, recorded date of birth (or age), sex and blood pressure at baseline and date of, or age at, death during follow-up. Outcome measures: We used Cox regression models to estimate relationships between educational attainment and CVD (fatal or non-fatal), as well as allcause, cardiovascular and cancer mortality. Results: During more than two million person-years of follow-up, 11 065 deaths (3655 from CVD and 4313 from cancer) and 1809 CVD non-fatal events were recorded. Adjusting for classical CVD risk factors and alcohol drinking, hazard ratios (95% CIs) for primary relative to tertiary education in Asia (Australasia) were 1.81 (1.38, 2.36) (1.10 (0.99, 1.22)) for all-cause mortality, 2.47(1.47, 4.17) (1.24 (1.02, 1.51)) for CVD mortality, 1.66 (1.00, 2.78) (1.01 (0.87, 1.17)) for cancer mortality and 2.09 (1.34, 3.26) (1.23 (1.04, 1.46)) for all CVD. Conclusions: Lower educational attainment is associated with a higher risk of CVD or premature mortality in Asia, to a degree exceeding that in the Western populations of Australasia. 2015 Journal Article http://hdl.handle.net/20.500.11937/14436 10.1136/bmjopen-2014-006408 fulltext
spellingShingle Woodward, M.
Peters, S.
Batty, G.
Ueshima, H.
Woo, J.
Giles, G.
Barzi, F.
Ho, S.
Huxley, Rachel
Arima, H.
Fang, X.
Dobson, A.
Lam, T.
Vathesatogkit, P.
Socioeconomic status in relation to cardiovascular disease and causespecific mortality: A comparison of Asian and Australasian populations in a pooled analysis
title Socioeconomic status in relation to cardiovascular disease and causespecific mortality: A comparison of Asian and Australasian populations in a pooled analysis
title_full Socioeconomic status in relation to cardiovascular disease and causespecific mortality: A comparison of Asian and Australasian populations in a pooled analysis
title_fullStr Socioeconomic status in relation to cardiovascular disease and causespecific mortality: A comparison of Asian and Australasian populations in a pooled analysis
title_full_unstemmed Socioeconomic status in relation to cardiovascular disease and causespecific mortality: A comparison of Asian and Australasian populations in a pooled analysis
title_short Socioeconomic status in relation to cardiovascular disease and causespecific mortality: A comparison of Asian and Australasian populations in a pooled analysis
title_sort socioeconomic status in relation to cardiovascular disease and causespecific mortality: a comparison of asian and australasian populations in a pooled analysis
url http://hdl.handle.net/20.500.11937/14436