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Lower level of education linked with increased risk for chronic HF
Christensen S. Eur Heart J. 2010;doi:10.1093/eurheartj/ehq435.
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Education level was associated with cardiac dysfunction and predictive of future hospitalization due to chronic HF, according to data from the Copenhagen City Heart Study.
The prospective cohort included 18,616 participants without known MI or chronic HF at baseline. The primary endpoint was first-ever hospital admission with a diagnosis of chronic HF. Educational levels were defined as low (<8 years), intermediary (8-10 years) and high (>10 years). Periods of examination included 1976 to 1978, 1981 to 1983, 1991 to 1994 and 2001 to 2003.
During follow-up (median, 21 years), the primary endpoint occurred in 2,190 participants. Age-adjusted HRs, when using low-level group as reference, were 0.69 (95% CI, 0.62-0.78) in the intermediary and 0.52 (95% CI, 0.43-0.63) in the high-level groups. After adjustment for CV risk factors, the HR in the intermediary group was 0.75 (95% CI, 0.67-0.85) and 0.61 (95% CI, 0.50-0.73) in the high-level group.
These findings, the researchers wrote, “show that level of education is associated with early systolic and diastolic dysfunction assessed by echocardiography and is a strong predictor of future hospital admission for HF. Only a minor part of the excess risk was mediated by differences in potentially modifiable cardiovascular risk factors.”
Further studies are needed to explain the remaining excess and strengthen strategies to reduce this inequality, they concluded.
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