Socioeconomic Indicators and the Risk of Acute Coronary Heart Disease Events: Comparison of Population-Based Data from the United States and Finland

Anna M. Kucharska-Newton; Kennet Harald; Wayne D. Rosamond; Kathryn M. Rose; Thomas D. Rea; Veikko Salomaa

doi:10.1016/j.annepidem.2011.04.006

Socioeconomic Indicators and the Risk of Acute Coronary Heart Disease Events: Comparison of Population-Based Data from the United States and Finland

Anna M. Kucharska-Newton, Kennet Harald, Wayne D. Rosamond, Kathryn M. Rose, Thomas D. Rea, Veikko Salomaa

Research output: Contribution to journal › Article › peer-review

71 Scopus citations

Abstract

Purpose: We wished to determine whether a gradient of association of low socioeconomic status with incidence of coronary heart disease was present in two population-based cohorts, one from United States and the other from Finland. Methods: Using data from the Atherosclerosis Risk in Communities (ARIC) cohort and the Finnish FINRISK cohort, we estimated, with Cox proportional hazard regression models, incidence of sudden cardiac death (SCD), non-sudden cardiac death (NSCD), and non-fatal myocardial infarction (NFMI) for strata of income and education (follow-up: 1987-2001). In both cohorts, incidence rates of the three outcomes increased across all socioeconomic status exposure categories. Results: Low education was associated with increased hazard of NFMI in both cohorts and with increased risk of SCD among ARIC women. Low income was significantly associated with increased hazard of all three outcomes among ARIC women and with increased hazard of cardiac death among ARIC men. In FINRISK, low income was significantly associated with increased risk of SCD only. Risk of SCD in the low income categories was similar for both cohorts. Smoking, alcohol consumption, and race (ARIC only) did not appreciably alter effect estimates in either cohort. Conclusions: Indices of low SES show similar associations with increased risk of cardiac events in Finland and in United States.

Original language	English
Pages (from-to)	572-579
Number of pages	8
Journal	Annals of Epidemiology
Volume	21
Issue number	8
DOIs	https://doi.org/10.1016/j.annepidem.2011.04.006
State	Published - Aug 2011

Bibliographical note

Funding Information:
The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute ( N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022 ). This work was also supported by a National Research Service Award training grant ( T32 H2-0007055 to A.M.K.-N.). The FINRISK study has been funded by the National Institute for Health and Welfare, Helsinki, Finland. Additionally, Dr. Salomaa has received support from the Finnish Foundation for Cardiovascular Research. The authors thank the staff and participants of the ARIC study and the FINRISK study for their important contributions.

Keywords

Cohort Studies
Non-Fatal MI
Socioeconomic Factors
Sudden Cardiac Death

ASJC Scopus subject areas

Epidemiology

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10.1016/j.annepidem.2011.04.006

Cite this

@article{04acadeebb77451ab8bdef41039af320,

title = "Socioeconomic Indicators and the Risk of Acute Coronary Heart Disease Events: Comparison of Population-Based Data from the United States and Finland",

abstract = "Purpose: We wished to determine whether a gradient of association of low socioeconomic status with incidence of coronary heart disease was present in two population-based cohorts, one from United States and the other from Finland. Methods: Using data from the Atherosclerosis Risk in Communities (ARIC) cohort and the Finnish FINRISK cohort, we estimated, with Cox proportional hazard regression models, incidence of sudden cardiac death (SCD), non-sudden cardiac death (NSCD), and non-fatal myocardial infarction (NFMI) for strata of income and education (follow-up: 1987-2001). In both cohorts, incidence rates of the three outcomes increased across all socioeconomic status exposure categories. Results: Low education was associated with increased hazard of NFMI in both cohorts and with increased risk of SCD among ARIC women. Low income was significantly associated with increased hazard of all three outcomes among ARIC women and with increased hazard of cardiac death among ARIC men. In FINRISK, low income was significantly associated with increased risk of SCD only. Risk of SCD in the low income categories was similar for both cohorts. Smoking, alcohol consumption, and race (ARIC only) did not appreciably alter effect estimates in either cohort. Conclusions: Indices of low SES show similar associations with increased risk of cardiac events in Finland and in United States.",

keywords = "Cohort Studies, Non-Fatal MI, Socioeconomic Factors, Sudden Cardiac Death",

author = "Kucharska-Newton, {Anna M.} and Kennet Harald and Rosamond, {Wayne D.} and Rose, {Kathryn M.} and Rea, {Thomas D.} and Veikko Salomaa",

note = "Funding Information: The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute ( N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022 ). This work was also supported by a National Research Service Award training grant ( T32 H2-0007055 to A.M.K.-N.). The FINRISK study has been funded by the National Institute for Health and Welfare, Helsinki, Finland. Additionally, Dr. Salomaa has received support from the Finnish Foundation for Cardiovascular Research. The authors thank the staff and participants of the ARIC study and the FINRISK study for their important contributions.",

year = "2011",

month = aug,

doi = "10.1016/j.annepidem.2011.04.006",

language = "English",

volume = "21",

pages = "572--579",

number = "8",

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T1 - Socioeconomic Indicators and the Risk of Acute Coronary Heart Disease Events

T2 - Comparison of Population-Based Data from the United States and Finland

AU - Kucharska-Newton, Anna M.

AU - Harald, Kennet

AU - Rosamond, Wayne D.

AU - Rose, Kathryn M.

AU - Rea, Thomas D.

AU - Salomaa, Veikko

N1 - Funding Information: The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute ( N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022 ). This work was also supported by a National Research Service Award training grant ( T32 H2-0007055 to A.M.K.-N.). The FINRISK study has been funded by the National Institute for Health and Welfare, Helsinki, Finland. Additionally, Dr. Salomaa has received support from the Finnish Foundation for Cardiovascular Research. The authors thank the staff and participants of the ARIC study and the FINRISK study for their important contributions.

PY - 2011/8

Y1 - 2011/8

N2 - Purpose: We wished to determine whether a gradient of association of low socioeconomic status with incidence of coronary heart disease was present in two population-based cohorts, one from United States and the other from Finland. Methods: Using data from the Atherosclerosis Risk in Communities (ARIC) cohort and the Finnish FINRISK cohort, we estimated, with Cox proportional hazard regression models, incidence of sudden cardiac death (SCD), non-sudden cardiac death (NSCD), and non-fatal myocardial infarction (NFMI) for strata of income and education (follow-up: 1987-2001). In both cohorts, incidence rates of the three outcomes increased across all socioeconomic status exposure categories. Results: Low education was associated with increased hazard of NFMI in both cohorts and with increased risk of SCD among ARIC women. Low income was significantly associated with increased hazard of all three outcomes among ARIC women and with increased hazard of cardiac death among ARIC men. In FINRISK, low income was significantly associated with increased risk of SCD only. Risk of SCD in the low income categories was similar for both cohorts. Smoking, alcohol consumption, and race (ARIC only) did not appreciably alter effect estimates in either cohort. Conclusions: Indices of low SES show similar associations with increased risk of cardiac events in Finland and in United States.

AB - Purpose: We wished to determine whether a gradient of association of low socioeconomic status with incidence of coronary heart disease was present in two population-based cohorts, one from United States and the other from Finland. Methods: Using data from the Atherosclerosis Risk in Communities (ARIC) cohort and the Finnish FINRISK cohort, we estimated, with Cox proportional hazard regression models, incidence of sudden cardiac death (SCD), non-sudden cardiac death (NSCD), and non-fatal myocardial infarction (NFMI) for strata of income and education (follow-up: 1987-2001). In both cohorts, incidence rates of the three outcomes increased across all socioeconomic status exposure categories. Results: Low education was associated with increased hazard of NFMI in both cohorts and with increased risk of SCD among ARIC women. Low income was significantly associated with increased hazard of all three outcomes among ARIC women and with increased hazard of cardiac death among ARIC men. In FINRISK, low income was significantly associated with increased risk of SCD only. Risk of SCD in the low income categories was similar for both cohorts. Smoking, alcohol consumption, and race (ARIC only) did not appreciably alter effect estimates in either cohort. Conclusions: Indices of low SES show similar associations with increased risk of cardiac events in Finland and in United States.

KW - Cohort Studies

KW - Non-Fatal MI

KW - Socioeconomic Factors

KW - Sudden Cardiac Death

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JO - Annals of Epidemiology

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ER -

Socioeconomic Indicators and the Risk of Acute Coronary Heart Disease Events: Comparison of Population-Based Data from the United States and Finland

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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