Neighbourhood socioeconomic status and coronary heart disease in individuals between 40 and 50 years
Neighbourhood socioeconomic status and coronary heart disease in individuals between 40 and 50 years
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DOI：
10.1136/heartjnl-2015-308784
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发表时间：
2016-05-01
期刊：
影响因子：
5.7
通讯作者：
Sundquist, Kristina
中科院分区：
文献类型：
--
作者：
Carlsson, Axel C.;Li, Xinjun;Sundquist, Kristina
目的心肌梗死（MI）的发病率普遍下降，但在中青年中没有下降。我们对40岁时社区社会经济地位（SES）与50岁前心肌梗死风险之间的关系进行了一项队列研究。方法所有瑞典人在其40岁生日的年份纳入，如果发生在1998年至2010年之间。使用国家登记册将社区SES分为高、中、低，并检索心肌梗死和冠心病（CHD）事件的信息。Cox回归模型对婚姻状况、教育水平、移民身份和居住地区进行了调整，提供了心肌梗死或冠心病的hr和95% ci的估计。结果男性587 933例，女性563 719例，男性2877例（0.48%），女性932例（0.17%）；在平均5.5年的随访期间，有4400名（0.74%）男性和1756名（0.31%）女性发生冠心病。以生活在中等社会经济地位社区的个体为参照，生活在高社会经济地位社区的男女患心肌梗死的风险均较低(HR (95% CI)：男性：0.72(0.64至0.82)，女性：0.66(0.53至0.81))；生活在低社会经济地位的社区与较高的心肌梗死风险相关(HR (95% CI)：男性：1.31（1.20至1.44)，女性：1.28(1.08至1.50)）。冠心病的风险估计值也相似。结论与中等社会经济地位的居民相比，低社会经济地位的居民发生心肌梗死和冠心病的风险增加，而高社会经济地位的居民发生心肌梗死和冠心病的风险较低。
Objective The incidence of myocardial infarction (MI) has decreased in general but not among younger middle-aged adults. We performed a cohort study of the association between neighbourhood socioeconomic status (SES) at the age of 40 and risk of MI before the age of 50 years.Methods All individuals in Sweden were included in the year of their 40th birthday, if it occurred between 1998 and 2010. National registers were used to categorise neighbourhood SES into high, middle and low, and to retrieve information on incident MI and coronary heart disease (CHD). Cox regression models, adjusted for marital status, education level, immigrant status and region of residence, provided an estimate of the HRs and 95% CIs for MI or CHD.Results Out of 587 933 men and 563 719 women, incident MI occurred in 2877 (0.48%) men and 932 (0.17%) women; and CHD occurred in 4400 (0.74%) men and 1756 (0.31%) women during a mean follow-up of 5.5 years. Using individuals living in middle-SES neighbourhoods as referents, living in high-SES neighbourhoods was associated with lower risk of MI in both sexes (HR (95% CI): men: 0.72 (0.64 to 0.82), women: 0.66 (0.53 to 0.81)); living in low-SES neighbourhoods was associated with a higher risk of MI (HR (95% CI): men: 1.31 (1.20 to 1.44), women: 1.28 (1.08 to 1.50)). Similar risk estimates for CHD were found.Conclusions The results of our study suggest an increased risk of MI and CHD among residents from low-SES neighbourhoods and a lower risk in those from high-SES neighbourhoods compared with residents in middle-SES neighbourhoods.