The impact of the combination of income and education on the incidence of coronary heart disease in the prospective Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study

We investigated the association between income-education groups and incident coronary heart disease (CHD) in a national prospective cohort study. The REasons for Geographic And Racial Differences in Stroke study recruited 30,239 black and white community-dwelling adults between 2003 and 2007 and col...

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Veröffentlicht in:BMC public health 2015-12, Vol.15 (10913), p.1312-1312, Article 1312
Hauptverfasser: Lewis, Marquita W, Khodneva, Yulia, Redmond, Nicole, Durant, Raegan W, Judd, Suzanne E, Wilkinson, Larrell L, Howard, Virginia J, Safford, Monika M
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container_issue 10913
container_start_page 1312
container_title BMC public health
container_volume 15
creator Lewis, Marquita W
Khodneva, Yulia
Redmond, Nicole
Durant, Raegan W
Judd, Suzanne E
Wilkinson, Larrell L
Howard, Virginia J
Safford, Monika M
description We investigated the association between income-education groups and incident coronary heart disease (CHD) in a national prospective cohort study. The REasons for Geographic And Racial Differences in Stroke study recruited 30,239 black and white community-dwelling adults between 2003 and 2007 and collected participant-reported and in-home physiologic variables at baseline, with expert adjudicated CHD endpoints during follow-up. Mutually exclusive income-education groups were: low income (annual household income
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The REasons for Geographic And Racial Differences in Stroke study recruited 30,239 black and white community-dwelling adults between 2003 and 2007 and collected participant-reported and in-home physiologic variables at baseline, with expert adjudicated CHD endpoints during follow-up. Mutually exclusive income-education groups were: low income (annual household income &lt;$35,000)/low education (&lt; high school), low income/high education, high income/low education, and high income/high education. Cox models estimated hazard ratios (HR) for incident CHD for each exposure group, examining differences by age group. At baseline, 24,461 participants free of CHD experienced 809 incident CHD events through December 31, 2011 (median follow-up 6.0 years; interquartile range 4.5-7.3 years). Those with low income/low education had the highest incidence of CHD (10.1 [95% CI 8.4-12.1]/1000 person-years). After full adjustment, those with low income/low education had higher risk of incident CHD (HR 1.42 [95% CI: 1.14-1.76]) than those with high income/high education, but findings varied by age. Among those aged &lt;65 years, compared with those reporting high income/high education, risk of incident CHD was significantly higher for those reporting low income/low education and low income/high education (adjusted HR 2.07 [95% CI 1.42-3.01] and 1.69 [95% CI 1.30-2.20], respectively). Those aged ≥ 65 years, risk of incident CHD was similar across income-education groups after full adjustment. For younger individuals, low income, regardless of education, was associated with higher risk of CHD, but not observed for ≥ 65 years. Findings suggest that for younger participants, education attainment may not overcome the disadvantage conferred by low income in terms of CHD risk, whereas among those ≥ 65 years, the independent effects of income and education are less pronounced.</description><identifier>ISSN: 1471-2458</identifier><identifier>EISSN: 1471-2458</identifier><identifier>DOI: 10.1186/s12889-015-2630-4</identifier><identifier>PMID: 26715537</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>African Continental Ancestry Group ; Age Distribution ; Aged ; Analysis ; Cardiovascular disease ; Coronary Artery Disease - epidemiology ; Coronary Artery Disease - ethnology ; Demographic aspects ; European Continental Ancestry Group ; Female ; Health risk assessment ; Heart attack ; Heart attacks ; Humans ; Incidence ; Income ; Male ; Middle Aged ; Mortality ; Poverty ; Proportional Hazards Models ; Prospective Studies ; Risk ; Risk factors ; Sex Distribution ; Social economics ; Socioeconomic Factors</subject><ispartof>BMC public health, 2015-12, Vol.15 (10913), p.1312-1312, Article 1312</ispartof><rights>COPYRIGHT 2015 BioMed Central Ltd.</rights><rights>Copyright BioMed Central 2015</rights><rights>Lewis et al. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-23939e4ead08873871ed9cba04f309642eaae21fcff34b610ed243cef6ec0b9e3</citedby><cites>FETCH-LOGICAL-c424t-23939e4ead08873871ed9cba04f309642eaae21fcff34b610ed243cef6ec0b9e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4696109/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4696109/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26715537$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lewis, Marquita W</creatorcontrib><creatorcontrib>Khodneva, Yulia</creatorcontrib><creatorcontrib>Redmond, Nicole</creatorcontrib><creatorcontrib>Durant, Raegan W</creatorcontrib><creatorcontrib>Judd, Suzanne E</creatorcontrib><creatorcontrib>Wilkinson, Larrell L</creatorcontrib><creatorcontrib>Howard, Virginia J</creatorcontrib><creatorcontrib>Safford, Monika M</creatorcontrib><title>The impact of the combination of income and education on the incidence of coronary heart disease in the prospective Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study</title><title>BMC public health</title><addtitle>BMC Public Health</addtitle><description>We investigated the association between income-education groups and incident coronary heart disease (CHD) in a national prospective cohort study. The REasons for Geographic And Racial Differences in Stroke study recruited 30,239 black and white community-dwelling adults between 2003 and 2007 and collected participant-reported and in-home physiologic variables at baseline, with expert adjudicated CHD endpoints during follow-up. Mutually exclusive income-education groups were: low income (annual household income &lt;$35,000)/low education (&lt; high school), low income/high education, high income/low education, and high income/high education. Cox models estimated hazard ratios (HR) for incident CHD for each exposure group, examining differences by age group. At baseline, 24,461 participants free of CHD experienced 809 incident CHD events through December 31, 2011 (median follow-up 6.0 years; interquartile range 4.5-7.3 years). Those with low income/low education had the highest incidence of CHD (10.1 [95% CI 8.4-12.1]/1000 person-years). After full adjustment, those with low income/low education had higher risk of incident CHD (HR 1.42 [95% CI: 1.14-1.76]) than those with high income/high education, but findings varied by age. Among those aged &lt;65 years, compared with those reporting high income/high education, risk of incident CHD was significantly higher for those reporting low income/low education and low income/high education (adjusted HR 2.07 [95% CI 1.42-3.01] and 1.69 [95% CI 1.30-2.20], respectively). Those aged ≥ 65 years, risk of incident CHD was similar across income-education groups after full adjustment. For younger individuals, low income, regardless of education, was associated with higher risk of CHD, but not observed for ≥ 65 years. Findings suggest that for younger participants, education attainment may not overcome the disadvantage conferred by low income in terms of CHD risk, whereas among those ≥ 65 years, the independent effects of income and education are less pronounced.</description><subject>African Continental Ancestry Group</subject><subject>Age Distribution</subject><subject>Aged</subject><subject>Analysis</subject><subject>Cardiovascular disease</subject><subject>Coronary Artery Disease - epidemiology</subject><subject>Coronary Artery Disease - ethnology</subject><subject>Demographic aspects</subject><subject>European Continental Ancestry Group</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Heart attack</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Incidence</subject><subject>Income</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Poverty</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Risk</subject><subject>Risk factors</subject><subject>Sex Distribution</subject><subject>Social economics</subject><subject>Socioeconomic Factors</subject><issn>1471-2458</issn><issn>1471-2458</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNptks9u1DAQxiMEoqXwAFyQJS7lkOJ_iZML0qotW6RKSNtythxnvOuS2MFOKvX1-mQ4u9tVi5APdmZ-803G_rLsI8FnhFTl10hoVdU5JkVOS4Zz_io7JlyQnPKiev3sfJS9i_EOYyKqgr7NjmgpSFEwcZw93m4A2X5QekTeoDF9ad831qnRejeHrEsBQMq1CNpJ7-Nui6acbcFpmEHtg3cqPKANqDCi1kZQcWa26BB8HECP9h7QKiW8i8j4gJbg10ENG6u3LVZKW9WhC2sMhFk5zgI3Y_C_AZ2uLpeL1cXNl9Rr41OPOE7tw_vsjVFdhA_7_ST79f3y9vwqv_65_HG-uM41p3zMKatZDRxUi6tKsEoQaGvdKMwNw3XJKSgFlBhtDONNSTC0lDMNpgSNmxrYSfZtpztMTQ-tBjcG1ckh2D5NLb2y8mXG2Y1c-3vJyzrJ1UngdC8Q_J8J4ih7GzV0nXLgpyiJKKhIv8aKhH7-B73zU3BpvESJuih4lV78QK1VB9I641NfPYvKBS9IKXApeKLO_kOl1UJvtXdgbIq_KCC7Ap3eLAYwhxkJlrPx5M54MhlPzsaTc82n55dzqHhyGvsLe8PWKw</recordid><startdate>20151229</startdate><enddate>20151229</enddate><creator>Lewis, Marquita W</creator><creator>Khodneva, Yulia</creator><creator>Redmond, Nicole</creator><creator>Durant, Raegan W</creator><creator>Judd, Suzanne E</creator><creator>Wilkinson, Larrell L</creator><creator>Howard, Virginia J</creator><creator>Safford, Monika M</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>L6V</scope><scope>M0S</scope><scope>M1P</scope><scope>M7S</scope><scope>PATMY</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20151229</creationdate><title>The impact of the combination of income and education on the incidence of coronary heart disease in the prospective Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study</title><author>Lewis, Marquita W ; Khodneva, Yulia ; Redmond, Nicole ; Durant, Raegan W ; Judd, Suzanne E ; Wilkinson, Larrell L ; Howard, Virginia J ; Safford, Monika M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-23939e4ead08873871ed9cba04f309642eaae21fcff34b610ed243cef6ec0b9e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>African Continental Ancestry Group</topic><topic>Age Distribution</topic><topic>Aged</topic><topic>Analysis</topic><topic>Cardiovascular disease</topic><topic>Coronary Artery Disease - epidemiology</topic><topic>Coronary Artery Disease - ethnology</topic><topic>Demographic aspects</topic><topic>European Continental Ancestry Group</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Heart attack</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Incidence</topic><topic>Income</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Poverty</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Risk</topic><topic>Risk factors</topic><topic>Sex Distribution</topic><topic>Social economics</topic><topic>Socioeconomic Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lewis, Marquita W</creatorcontrib><creatorcontrib>Khodneva, Yulia</creatorcontrib><creatorcontrib>Redmond, Nicole</creatorcontrib><creatorcontrib>Durant, Raegan W</creatorcontrib><creatorcontrib>Judd, Suzanne E</creatorcontrib><creatorcontrib>Wilkinson, Larrell L</creatorcontrib><creatorcontrib>Howard, Virginia J</creatorcontrib><creatorcontrib>Safford, Monika M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Health &amp; 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The REasons for Geographic And Racial Differences in Stroke study recruited 30,239 black and white community-dwelling adults between 2003 and 2007 and collected participant-reported and in-home physiologic variables at baseline, with expert adjudicated CHD endpoints during follow-up. Mutually exclusive income-education groups were: low income (annual household income &lt;$35,000)/low education (&lt; high school), low income/high education, high income/low education, and high income/high education. Cox models estimated hazard ratios (HR) for incident CHD for each exposure group, examining differences by age group. At baseline, 24,461 participants free of CHD experienced 809 incident CHD events through December 31, 2011 (median follow-up 6.0 years; interquartile range 4.5-7.3 years). Those with low income/low education had the highest incidence of CHD (10.1 [95% CI 8.4-12.1]/1000 person-years). After full adjustment, those with low income/low education had higher risk of incident CHD (HR 1.42 [95% CI: 1.14-1.76]) than those with high income/high education, but findings varied by age. Among those aged &lt;65 years, compared with those reporting high income/high education, risk of incident CHD was significantly higher for those reporting low income/low education and low income/high education (adjusted HR 2.07 [95% CI 1.42-3.01] and 1.69 [95% CI 1.30-2.20], respectively). Those aged ≥ 65 years, risk of incident CHD was similar across income-education groups after full adjustment. For younger individuals, low income, regardless of education, was associated with higher risk of CHD, but not observed for ≥ 65 years. Findings suggest that for younger participants, education attainment may not overcome the disadvantage conferred by low income in terms of CHD risk, whereas among those ≥ 65 years, the independent effects of income and education are less pronounced.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>26715537</pmid><doi>10.1186/s12889-015-2630-4</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record>
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subjects African Continental Ancestry Group
Age Distribution
Aged
Analysis
Cardiovascular disease
Coronary Artery Disease - epidemiology
Coronary Artery Disease - ethnology
Demographic aspects
European Continental Ancestry Group
Female
Health risk assessment
Heart attack
Heart attacks
Humans
Incidence
Income
Male
Middle Aged
Mortality
Poverty
Proportional Hazards Models
Prospective Studies
Risk
Risk factors
Sex Distribution
Social economics
Socioeconomic Factors
title The impact of the combination of income and education on the incidence of coronary heart disease in the prospective Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study
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