RT Journal Article
SR Electronic
T1 Cardiovascular disease mortality in relation to childhood and adulthood socioeconomic markers in British South Asian men
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 476
OP 481
DO 10.1136/hrt.2006.109165
VO 94
IS 4
A1 T Tillin
A1 N Chaturvedi
A1 N G Forouhi
A1 G D Smith
A1 P M McKeigue
YR 2008
UL http://heart.bmj.com/content/94/4/476.abstract
AB Objective: To study the effects of childhood and adulthood socioeconomic position (SEP) including length of education on rates of cardiovascular disease (CVD) mortality in British South Asians.Design: Cross-sectional study with ongoing mortality follow-up.Setting: West London Borough of Ealing, population-based study.Patients: 1400 South Asian men (52% Punjabi Sikh origin) aged 40–69, first studied 1988–1990 and followed for mortality to October 2006.Main outcome measures: Deaths due to cardiovascular disease.Results: 143 men have died from CVD. Men in non-manual adult occupations were less likely to die from CVD than those in unskilled manual occupations (age-adjusted hazard ratio (HR) 0.55 (95% CI 0.35 to 0.88)). Men with 11+ years of education had reduced risk compared with those with <11 years of education (HR 0.66 (95% CI 0.47 to 0.94)). Men who had both non-manual occupations and 11+ years of education were less likely to die from CVD (15 deaths, 282 men; HR 0.39, 95% CI 0.21 to 0.73) than those who were most socially disadvantaged during childhood and adulthood (27 deaths, 187 men). These associations remained after adjustment for other markers of SEP, lifestyle and conventional risk factors. Similar, but weaker, associations were observed when paternal occupation defined childhood SEP.Conclusions: Years of education, and to a lesser extent paternal occupation, as markers of childhood SEP, had cumulative effects with adulthood socioeconomic circumstances on risk of CVD death; these cumulative effects were strongest in men whose own occupation was non-manual and were unexplained by conventional risk factors measured in middle age.