Cross-sectional analysis of educational inequalities in primary prevention statin use in UK Biobank.

Cross-sectional analysis of educational inequalities in primary prevention statin use in UK Biobank.
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英国生物库中汀类药物使用汀类药物的教育不平等的横断面分析。

DOI:
10.1136/heartjnl-2021-319238
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发表时间:
2022-04
期刊:
Heart (British Cardiac Society)
影响因子:
--
通讯作者:
Howe LD
Howe LD
中科院分区:
其他
文献类型:
--
作者:
Carter AR;Gill D;Davey Smith G;Taylor AE;Davies NM;Howe LD

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确定受教育程度较低的参与者是否报告服用他汀类药物作为心血管一级预防的可能性低于受教育程度较高的参与者,但潜在的心血管风险也有同等程度的增加。使用来自大型前瞻性队列研究英国生物库的数据,我们计算了472097名符合条件的参与者的QRISK3心血管风险评分,这些参与者具有自我报告的教育程度和他汀类药物使用的完整数据(55%是女性参与者;平均年龄56岁)。我们使用Logistic回归来探索(I)QRISK3分数和(Ii)教育程度对自我报告的他汀类药物使用的关系。然后,我们根据教育程度对QRISK3得分和他汀类药物使用之间的联系进行分层,以测试交互作用。有证据表明QRISK3分数和教育程度之间存在交互作用。QRISK3得分每增加一个单位,受教育程度越高的人报告服用他汀类药物的可能性就越大。在受过7年≤教育的女性中,QRISK3得分每增加一个单位,使用他汀类药物的几率就会增加7%(OR1.07,95% 可信区间1.07至1.07)。在受过20年≥教育的女性中,QRISK3得分每增加一个单位,使用他汀类药物的几率就增加14%(OR1.14,95% 可信区间1.14至1.15)。男性受教育7年的可比OR值为1.04(95%可信区间1.04~1.05),≤20年的可比OR值为1.08(95%可信区间1.08,1.08)。QRISK3得分的单位增加,教育程度较低的个人报告使用他汀类药物的可能性较小,这可能导致健康不平等。
Identify whether participants with lower education are less likely to report taking statins for primary cardiovascular prevention than those with higher education, but an equivalent increase in underlying cardiovascular risk. Using data from a large prospective cohort study, UK Biobank, we calculated a QRISK3 cardiovascular risk score for 472 097 eligible participants with complete data on self-reported educational attainment and statin use (55% female participants; mean age 56 years). We used logistic regression to explore the association between (i) QRISK3 score and (ii) educational attainment on self-reported statin use. We then stratified the association between QRISK3 score and statin use, by educational attainment to test for interactions. There was evidence of an interaction between QRISK3 score and educational attainment. Per unit increase in QRISK3 score, more educated individuals were more likely to report taking statins. In women with ≤7 years of schooling, a one unit increase in QRISK3 score was associated with a 7% higher odds of statin use (OR 1.07, 95% CI 1.07 to 1.07). In women with ≥20 years of schooling, a one unit increase in QRISK3 score was associated with an 14% higher odds of statin use (OR 1.14, 95% CI 1.14 to 1.15). Comparable ORs in men were 1.04 (95% CI 1.04 to 1.05) for ≤7 years of schooling and 1.08 (95% CI 1.08, 1.08) for ≥20 years of schooling. Per unit increase in QRISK3 score, individuals with lower educational attainment were less likely to report using statins, likely contributing to health inequalities.
DOI: 10.1093/aje/kwx246
发表时间: 2017-11-01
影响因子: 5
作者:
Fry A;Littlejohns TJ;Sudlow C;Doherty N;Adamska L;Sprosen T;Collins R;Allen NE
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