Evaluating the evidence for models of life course socioeconomic factors and cardiovascular outcomes: a systematic review.
Evaluating the evidence for models of life course socioeconomic factors and cardiovascular outcomes: a systematic review.
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DOI：
10.1186/1471-2458-5-7
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发表时间：
2005-01-20
影响因子：
4.5
通讯作者：
Kaufman JS
中科院分区：
文献类型：
--
作者：
Pollitt RA;Rose KM;Kaufman JS
一个相对一致的研究机构支持社会经济地位（SES）和心血管疾病（CVD）之间的反比关系。最近，研究人员提出了各种生命历程SES假说，认为不同环境和经历的组合、积累和/或相互作用会影响成年期CVD的风险。不同的生命历程设计已被用来检查SES的影响，在整个生命历程。本系统综述描述了四种最常见的生命历程假设，根据生命历程设计对研究生命历程SES与CVD之间关系的研究进行了分类，讨论了不同设计的优点和缺点，并总结了研究结果。这项研究回顾了生物医学文献中的49项观察性研究，其中包括成年期以外的社会经济指标作为自变量，并评估了亚临床CHD，CVD发病率和/或死亡率，和/或传统CVD危险因素的患病率作为其结果。根据生命历程设计和分析方法，将研究分为四组。在总结研究结果时考虑了研究作者的结论和统计检验。研究结果表明，低SES在整个生命过程中适度影响CVD危险因素和CVD风险。具体而言，研究审查提供了中度支持的作用，低早期生活SES和心血管疾病风险因素和心血管疾病的发病率和死亡率水平升高，很少支持的独特影响的社会流动性对心血管疾病，并一致支持的有害影响的积累负SES的经验/条件在整个生命过程中对心血管疾病的风险。虽然基本的生命历程SES研究设计有各种方法和概念上的局限性，他们提供了一个重要的方法来研究社会因素对CVD发展的影响。一些局限性可以通过分析研究队列从童年，在成年早期和中期的CVD危险因素的评估，并在每个生命历程研究中使用多个SES措施和多个生命历程分析方法来解决。
A relatively consistent body of research supports an inverse graded relationship between socioeconomic status (SES) and cardiovascular disease (CVD). More recently, researchers have proposed various life course SES hypotheses, which posit that the combination, accumulation, and/or interactions of different environments and experiences throughout life can affect adult risk of CVD. Different life course designs have been utilized to examine the impact of SES throughout the life course. This systematic review describes the four most common life course hypotheses, categorizes the studies that have examined the associations between life course SES and CVD according to their life course design, discusses the strengths and weaknesses of the different designs, and summarizes the studies' findings. This research reviewed 49 observational studies in the biomedical literature that included socioeconomic measures at a time other than adulthood as independent variables, and assessed subclinical CHD, incident CVD morbidity and/or mortality, and/or the prevalence of traditional CVD risk factors as their outcomes. Studies were categorized into four groups based upon life course design and analytic approach. The study authors' conclusions and statistical tests were considered in summarizing study results. Study results suggest that low SES throughout the life course modestly impacts CVD risk factors and CVD risk. Specifically, studies reviewed provided moderate support for the role of low early-life SES and elevated levels of CVD risk factors and CVD morbidity and mortality, little support for a unique influence of social mobility on CVD, and consistent support for the detrimental impact of the accumulation of negative SES experiences/conditions across the life course on CVD risk. While the basic life course SES study designs have various methodologic and conceptual limitations, they provide an important approach from which to examine the influence of social factors on CVD development. Some limitations may be addressed through the analysis of study cohorts followed from childhood, the evaluation of CVD risk factors in early and middle adulthood, and the use of multiple SES measures and multiple life course analysis approaches in each life course study.
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