on August 1, 2002
Published online before print August 1, 2002, doi: 10.1161/01.ATV.0000032006.75577.24
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Submitted on May 22, 2002
Accepted on July 15, 2002
Life-Course Perspective on Socioeconomic Differences in Carotid Atherosclerosis
Maria Rosvall *;
From the Department of Community Medicine (M.R., P.-O.O., B.H., S.-O.I., L.J.) and the Department of Medicine (B.H., G.B.), Orthopedics and Surgery, Lund University, Lund, Sweden.
* To whom correspondence should be addressed. E-mail: maria.rosvall{at}smi.mas.lu.se.
Objective—Socioeconomic status (SES) in adulthood is known to be related to carotid atherosclerosis. However, few studies have tried to assess its association with SES from a life-course perspective.
Methods and Results—We examined the relationship between SES in childhood and in adulthood and carotid atherosclerosis in a general population of Swedish men and women. Carotid stenosis was determined by B-mode ultrasound. Results showed that women whose fathers' occupations involved unskilled manual labor had higher odds of carotid stenosis than did women whose fathers' occupations involved high- or medium-level nonmanual labor, even after adjustment for adult occupational status and risk factors (odds ratio 1.8, 95% CI 1.1 to 2.8). No such association appeared in men. Furthermore, the impact of life-course SES on atherosclerosis was examined by using an additive measure of one's combined SES during childhood and adulthood. Among women, the odds of carotid stenosis increased with a rise in exposure to low SES during the life course (P for trend<0.001). In men, no such trend was found.
Conclusions—The results indicate that the total life-course exposure to low SES, with contributions from childhood and adulthood, seems to play a role in atherogenesis in women. Such a pattern of association could not be shown in men.
Key words: atherosclerosis • carotid arteries • life course • socioeconomic status
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