Abstracts
S83
Does individual risk prediction increase inequality? The issue of socioeconomic status as a risk predictor Friday, 15 May 2015, 14:00–15:30 403 Social inequalities in the incidence of coronary heart disease and ischemic stroke in Europe: a competing risk analysis. The MORGAM project cohort component
the MORGAM Project, G Giovanni Veronesi1, MM Ferrario1, LE Chambless2, K Kuulasmaa3, S Soderberg4, P Amouyel5, N Hart6, T Jorgensen7, A Peters8, H Tunstall-Pedoe9 1 University of Insubria, Research Centre in Epidemiology and Preventive Medicine - EPIMED, , Varese, Italy, 2University of North Carolina at Chapel Hill, department of biostatistics, Chapel Hill, United States of America, 3National Institute for Health and Welfare (THL), Helsinki, Finland, 4 Umea University, Department of Public Health and Clinical Medicine, Cardiology and Heart Centre, Umea, Sweden, 5Institute Pasteur of Lille, Department of Epidemiology & Public Health, Lille, France, 6Queen’s University of Belfast, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Belfast, United Kingdom, 7Glostrup University Hospital, Research Centre for Prevention and Health, Glostrup, Denmark, 8Helmholtz Center Munich German Research Center for Environment and Health, Munich, Germany, 9University of Dundee, Cardiovascular Epidemiology Unit, Institute of Cardiovascular Research, Dundee, United Kingdom
At mean age of 50, the bottom-to-top education differences in 10-year risk of CHD and IS were 2.7% and 0.5% in men; 1.2% and 0.3% in women (figure). In men, after adjusting for age, nonHDL- and HDL-cholesterol, blood pressure, diabetes and smoking, the pooled s-HRs for bottom to top education were 1.4 (95%CI:1.3-1.6) for CHD, and 1.4 (1.1-1.7) for IS. In Central Europe only the s-HR for IS was larger than for CHD (3.8,2.0-7.0; vs. 1.3,0.9-1.7). In women, the adjusted pooled s-HRs were 1.6 (95%CI:1.3-1.9) for CHD, with a North-South geographic gradient, and 1.2 (1.0-1.6) for IS. Conclusions: In these European populations, the global burden of educational inequalities in the incidence of major atherosclerotic CV events was mostly driven by CHD, with some geographic variation in men. Cumulative risks at age of 50
Topic: Social inequalities in cardiovascular health Purpose: To assess educational class inequalities in coronary heart disease (CHD) and ischemic stroke (IS) incidence in Europe using a competing risk approach. Methods: The MORGAM study comprised 33 cohorts from Nordic Countries (Finland, Denmark, Sweden), UK (Northern Ireland, Scotland) and Central EU (France, Germany, Northern Italy), enrolled following MONICA-like procedures mostly in mid 1980s and 1990s, with follow-up data (median length 12 years) on fatal and non-fatal CHD and IS. We derived 3 educational classes from population-, sex- and birth year-specific tertiles of years of schooling. From sex-specific Fine-Grey models we estimated the age-adjusted pooled cumulative incidence of CHD and IS for bottom and top education; and the relative increase in the cumulative incidence of CHD and IS for bottom compared to top education (sub-distribution Hazard Ratio, s-HR). The models included a dummy variable for each population. Results: The cohorts included 62,239 CVD-free subjects aged 35-64 (35,057 men) at baseline.
Downloaded from cpr.sagepub.com at Duke University Libraries on November 17, 2015
S83
Does individual risk prediction increase inequality? The issue of socioeconomic status as a risk predictor Friday, 15 May 2015, 14:00–15:30 403 Social inequalities in the incidence of coronary heart disease and ischemic stroke in Europe: a competing risk analysis. The MORGAM project cohort component
the MORGAM Project, G Giovanni Veronesi1, MM Ferrario1, LE Chambless2, K Kuulasmaa3, S Soderberg4, P Amouyel5, N Hart6, T Jorgensen7, A Peters8, H Tunstall-Pedoe9 1 University of Insubria, Research Centre in Epidemiology and Preventive Medicine - EPIMED, , Varese, Italy, 2University of North Carolina at Chapel Hill, department of biostatistics, Chapel Hill, United States of America, 3National Institute for Health and Welfare (THL), Helsinki, Finland, 4 Umea University, Department of Public Health and Clinical Medicine, Cardiology and Heart Centre, Umea, Sweden, 5Institute Pasteur of Lille, Department of Epidemiology & Public Health, Lille, France, 6Queen’s University of Belfast, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Belfast, United Kingdom, 7Glostrup University Hospital, Research Centre for Prevention and Health, Glostrup, Denmark, 8Helmholtz Center Munich German Research Center for Environment and Health, Munich, Germany, 9University of Dundee, Cardiovascular Epidemiology Unit, Institute of Cardiovascular Research, Dundee, United Kingdom
At mean age of 50, the bottom-to-top education differences in 10-year risk of CHD and IS were 2.7% and 0.5% in men; 1.2% and 0.3% in women (figure). In men, after adjusting for age, nonHDL- and HDL-cholesterol, blood pressure, diabetes and smoking, the pooled s-HRs for bottom to top education were 1.4 (95%CI:1.3-1.6) for CHD, and 1.4 (1.1-1.7) for IS. In Central Europe only the s-HR for IS was larger than for CHD (3.8,2.0-7.0; vs. 1.3,0.9-1.7). In women, the adjusted pooled s-HRs were 1.6 (95%CI:1.3-1.9) for CHD, with a North-South geographic gradient, and 1.2 (1.0-1.6) for IS. Conclusions: In these European populations, the global burden of educational inequalities in the incidence of major atherosclerotic CV events was mostly driven by CHD, with some geographic variation in men. Cumulative risks at age of 50
Topic: Social inequalities in cardiovascular health Purpose: To assess educational class inequalities in coronary heart disease (CHD) and ischemic stroke (IS) incidence in Europe using a competing risk approach. Methods: The MORGAM study comprised 33 cohorts from Nordic Countries (Finland, Denmark, Sweden), UK (Northern Ireland, Scotland) and Central EU (France, Germany, Northern Italy), enrolled following MONICA-like procedures mostly in mid 1980s and 1990s, with follow-up data (median length 12 years) on fatal and non-fatal CHD and IS. We derived 3 educational classes from population-, sex- and birth year-specific tertiles of years of schooling. From sex-specific Fine-Grey models we estimated the age-adjusted pooled cumulative incidence of CHD and IS for bottom and top education; and the relative increase in the cumulative incidence of CHD and IS for bottom compared to top education (sub-distribution Hazard Ratio, s-HR). The models included a dummy variable for each population. Results: The cohorts included 62,239 CVD-free subjects aged 35-64 (35,057 men) at baseline.
Downloaded from cpr.sagepub.com at Duke University Libraries on November 17, 2015
