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Socioeconomic status, education, and aortic stiffness progression over 5 years: the Whitehall II prospective cohort study.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Trudel, Xavier 
Shipley, Martin J 
McEniery, Carmel M 
Wilkinson, Ian B 
Brunner, Eric J 

Abstract

OBJECTIVE: The inverse association between socioeconomic status (SES) and cardiovascular disease (CVD) risk is well documented. Aortic stiffness assessed by aortic pulse wave velocity (PWV) is a strong predictor of CVD events. However, no previous study has examined the effect of SES on arterial stiffening over time. The present study examines this association, using several measures of SES, and attained education level in a large ageing cohort of British men and women. METHODS: Participants were drawn from the Whitehall II study. The sample was composed of 3836 men and 1406 women who attended the 2008-2009 clinical examination (mean age = 65.5 years). Aortic PWV was measured in 2008-2009 and in 2012-2013 by applanation tonometry. A total of 3484 participants provided PWV measurements on both occasions. The mean difference in 5-year PWV change was examined according to household income, education, employment grade, and father's social class, using linear mixed models. RESULTS: PWV increase [mean: confidence interval (m/s)] over 5 years was higher among participants with lower employment grade (0.38: 0.11-0.65), household income (0.58, 95%: 0.32-0.85), and education (0.30: 0.01, 0.58), after adjusting for sociodemographic variables, BMI, alcohol consumption, smoking, and other cardiovascular risk factors, namely SBP, mean arterial pressure, heart rate, cholesterol, diabetes, and antihypertensive use. CONCLUSION: The present study supports the presence of robust socioeconomic disparities in aortic stiffness progression. Our findings suggest that arterial aging could be an important pathophysiological pathway explaining the impact of lower SES on CVD risk.

Description

Keywords

Aged, Aorta, Educational Status, Employment, Female, Humans, Income, Male, Middle Aged, Prospective Studies, Pulse Wave Analysis, Risk Factors, Social Class, Socioeconomic Factors, United Kingdom, Vascular Stiffness

Journal Title

J Hypertens

Conference Name

Journal ISSN

0263-6352
1473-5598

Volume Title

34

Publisher

Ovid Technologies (Wolters Kluwer Health)
Sponsorship
Cambridge University Hospitals NHS Foundation Trust (CUH) (unknown)
British Heart Foundation (None)