CARDIOVASCULAR MEDICINE

Socioeconomic position in childhood and adult cardiovascular risk factors, vascular structure, and function: cardiovascular risk in young Finns study

M Kivimäki^1,*, G Davey Smith², M Juonala³, J E Ferrie⁴, L Keltikangas-Järvinen¹, M Elovainio¹, L Pulkki-Råback¹, J Vahtera⁵, M Leino³, J S A Viikari⁶, O T Raitakari⁷

¹ Department of Psychology, University of Helsinki, Helsinki, Finland
² Department of Social Medicine, University of Bristol, Bristol, UK
³ Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
⁴ University College London Medical School, London, UK
⁵ Finnish Institute of Occupational Health, Helsinki, Finland
⁶ Department of Medicine, University of Turku, Turku, Finland
⁷ Department of Clinical Physiology, University of Turku, Turku, Finland

Correspondence to:
Professor Mika Kivimäki
Department of Psychology, University of Helsinki, PO Box 9, FIN-00014 Helsinki, Finland; mika.kivimaki{at}ttl.fi

Objective: To examine the association of childhood socioeconomic position (SEP) with adult cardiovascular risk factors, vascular structure, and vascular function in a contemporary population of young adults.

Design: Population based prospective cohort study with baseline assessment in 1980.

Setting: Finland.

Participants: 856 men and 1066 women whose childhood SEP was determined by parental occupational status (manual, lower non-manual, upper non-manual) at age 3–18 years.

Main outcome measures: Cardiovascular risk factors, carotid artery intima–media thickness, and brachial artery flow mediated vasodilatation, assessed at age 24–39 years.

Results: After adjustment for age and adult SEP, systolic pressure was 2.3 mm Hg higher (p = 0.0002), high density lipoprotein (HDL) cholesterol 0.03 mmol/l lower (p = 0.02), and insulin resistance score (homeostasis model assessment index) 0.12 units greater (p = 0.05) among men; and systolic pressure was 1.3 mm Hg higher (p = 0.02), diastolic pressure 1.1 mm Hg higher (p = 0.01), and height 1.1 cm lower (p < 0.0001) among women for each step down the childhood SEP hierarchy. Lower childhood SEP was associated with a 20% increase in the odds of having a waist circumference > 102 cm in men and > 88 cm in women (overall p = 0.05). Childhood SEP was not associated with intima–media thickness, flow mediated vasodilatation, the metabolic syndrome, low density lipoprotein cholesterol, triglycerides, body mass index, alcohol consumption, or smoking.

Conclusions: Among adults under 40, low childhood SEP predicted higher blood pressure and central obesity and, among men, unfavourable HDL cholesterol and insulin resistance, independent of current SEP. No independent effects were found on adult vascular structure, vascular function, or health related behaviours at this life stage.

Abbreviations: CVD, cardiovascular disease; HDL, high density lipoprotein; HOMA, homeostasis model assessment; LDL, low density lipoprotein; SEP, socioeconomic position

Keywords: socioeconomic status; cardiovascular diseases; atherosclerosis; endothelial function; risk factors

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