Socioeconomic factors as predictors of incident heart failure
Socioeconomic factors as predictors of incident heart failure
复制标题
DOI：
10.1016/j.cardfail.2006.05.010
复制
发表时间：
2006-09-01
影响因子：
6
通讯作者：
Sundstrom, Johan
中科院分区：
文献类型：
--
作者：
Ingelsson, Erik;Lind, Lars;Sundstrom, Johan
背景：社会经济因素作为心力衰竭（HF）预测因素的研究很少，并且给出了相反的结果。此外，尚不清楚这些因素是否独立于心肌梗死和其他已知的心衰危险因素预测心衰事件。方法和结果：在一个以社区为基础的2314名无心衰、瓣膜疾病和既往心肌梗死的中年男性队列中，使用Cox比例风险分析检查社会经济因素作为心衰的预测因素。在多变量Cox比例风险模型中，校正了HF（高血压、糖尿病、心电图左心室厚、吸烟、血清胆固醇和中期心肌梗死）、低职业分类（低职业分类的风险比[HR] 1.55, 95%可信区间[CI] 1.03-2.35）、低教育水平（小学与大学的风险比[HR] 1.98, 95%可信区间[CI] 1.07-3.68）和未婚(HR 1.44，（未婚vs已婚的95% CI 0.99-2.10）增加HF的风险。结论：高职业分类和高学历的中年男性随后发生心衰的风险降低，未婚增加，其机制在很大程度上独立于心衰的既定危险因素，包括中期心肌梗死。需要进一步的研究来了解这些关联背后的机制。
Background: Studies of socioeconomic factors as predictors of heart failure (HF) are few and have given opposing results. Further, it is unknown if these factors predict incident HF independently of myocardial infarction and other established risk factors for HF.Methods and Results: In a community-based cohort of 2314 middle-age men free from HF, valvular disease, and previous myocardial infarction at baseline, socioeconomic factors were examined as predictors for HF using Cox proportional hazards analyses. In multivariable Cox proportional hazards models adjusted for established risk factors for HF (hypertension, diabetes, electrocardiographic left ventricular hypertrophy, smoking, serum cholesterol, and interim myocardial infarction), low occupational classification (hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.03-2.35 for low vs. high occupational classification), low education level (HR 1.98, 95% CI 1.07-3.68 for elementary school vs. college exam) and being unmarried (HR 1.44, 95% CI 0.99-2.10 for being unmarried vs. being married) increased the risk of HF.Conclusion: High occupational classification and high education level decreased, and being unmarried increased, the risk of subsequent HF in middle-age men, via mechanisms largely independent of established risk factors for HF, including an interim myocardial infarction. Further studies are needed to understand the mechanisms behind these associations.