Social Class and Cardiovascular Risk Factors in Danish Men
Social Class and Cardiovascular Risk Factors in Danish Men
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丹麦男性的社会阶层和心血管危险因素
DOI：
10.1177/140349489101900207
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发表时间：
1991
影响因子：
3.4
通讯作者：
H. Hollnagel
中科院分区：
文献类型：
--
作者：
L. Møller;T. Kristensen;H. Hollnagel
在过去的25年里，欧洲西北部和美国的一系列流行病学研究表明，社会阶层与心血管疾病(CVD)的发病率呈负相关，即社会阶层越低，发病率越高。在对这种负梯度的可能解释进行了分析的研究中，得出的结论是，传统的个体风险因素，如高血压、高血清胆固醇和吸烟，可以解释大约一半的差异。在一项对来自哥本哈根的504名男性的前瞻性研究中，参与者在40岁和51岁时接受了检查。在这两项检查中，除了一些心血管危险因素外，参与者的社会阶层也被记录下来。后者既包括传统的风险因素，也包括一些以前没有分析过的与社会阶层有关的因素。在51年的调查中，我们发现社会阶层与以下风险因素之间存在显著的负相关：血浆纤维蛋白原(p<；0.001)、身高矮小(p<；0.001)、吸烟(p<；0.001)、闲暇时间缺乏体育活动、倒班工作(p<；0.05)、工作压力(p<；0.05)、独居(p<；0.01)以及社交网络不佳(p<；0.05)。有两个因素与社会阶层显著相反：A型行为(P<；0.001)和工作中缺乏体力活动(P<；0.001)。在过去的10-15年里，许多国家显示出一种趋势，即加强社会阶层与心血管危险因素之间的联系。这一趋势在我们的队列中没有发现。已经讨论了观察到的一些社会不平等是否可能是由于选择，从而使在社会上具有良好心血管风险概况的人向上流动。在我们的研究中，我们发现没有支持这样的选择假说。
During the last 25 years, a series of epidemiological studies in North-Western Europe and U.S.A. have demonstrated a negative association between social class and the incidence of cardiovascular disease (CVD), that is, an increasing incidence the lower the social class. In studies where possible explanations of this negative gradient have been analyzed, it was concluded that the traditional individual risk factors, such as elevated blood pressure, high serum cholesterol, and smoking, could explain about one half of the differences demonstrated. In a prospective study of a cohort of 504 men from the County of Copenhagen, the participants were examined when 40 and 51 years old. At both examinations the social class of the participants was recorded in addition to a number of cardiovascular risk factors. The latter included both the traditional risk factors and some not previously analyzed in relation to social class. At the 51-year examination we found statistically significant negative associations between social class and the following risk factors: plasma fibrinogen (p < 0.001), short height (p < 0.001), smoking (p < 0.05), physical inactivity in leisure time (p < 0.01), shift work (p < 0.05), job strain (p < 0.05), living alone (p < 0.01), and having a poor social network (p < 0.05). Two factors showed a significant opposite association with social class: Type A behaviour (p < 0.001) and physical inactivity at work (p < 0.001). In the last 10-15 years, a tendency has been demonstrated in many countries towards a strengthened association between social class and cardiovascular risk factors. This tendency was not found in our cohort. It has been discussed whether some of the social inequalities observed could be due to selection, so that people with a favourable cardiovascular risk profile socially were upward mobile. We found no support for such a selection hypothesis in our study.