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Educational class i...
Educational class inequalities in the incidence of coronary heart disease in Europe
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Veronesi, Giovanni (author)
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Ferrario, Marco M. (author)
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Kuulasmaa, Kari (author)
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Bobak, Martin (author)
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Chambless, Lloyd E. (author)
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Salomaa, Veikko (author)
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- Söderberg, Stefan (author)
- Umeå universitet,Kardiologi,Heart Centre
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Pajak, Andrzej (author)
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Jorgensen, Torben (author)
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Amouyel, Philippe (author)
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Arveiler, Dominique (author)
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Drygas, Wojciech (author)
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Ferrieres, Jean (author)
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Giampaoli, Simona (author)
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Kee, Frank (author)
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Iacoviello, Licia (author)
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Malyutina, Sofia (author)
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Peters, Annette (author)
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Tamosiunas, Abdonas (author)
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Tunstall-Pedoe, Hugh (author)
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Cesana, Giancarlo (author)
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(creator_code:org_t)
- 2016-02-05
- 2016
- English.
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In: Heart. - : BMJ. - 1355-6037 .- 1468-201X. ; 102:12, s. 958-965
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https://push-zb.helm...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Objective: To estimate the burden of social inequalities in coronary heart disease (CHD) and to identify their major determinants in 15 European populations.Methods: The MORGAM (MOnica Risk, Genetics, Archiving and Monograph) study comprised 49 cohorts of middle-aged European adults free of CHD (110 928 individuals) recruited mostly in the mid-1980s and 1990s, with comparable assessment of baseline risk and follow-up procedures. We derived three educational classes accounting for birth cohorts and used regression-based inequality measures of absolute differences in CHD rates and HRs (ie, Relative Index of Inequality, RII) for the least versus the most educated individuals.Results: N=6522 first CHD events occurred during a median follow-up of 12 years. Educational class inequalities accounted for 343 and 170 additional CHD events per 100 000 person-years in the least educated men and women compared with the most educated, respectively. These figures corresponded to 48% and 71% of the average event rates in each gender group. Inequalities in CHD mortality were mainly driven by incidence in the Nordic countries, Scotland and Lithuania, and by 28-day case-fatality in the remaining central/South European populations. The pooled RIIs were 1.6 (95% CI 1.4 to 1.8) in men and 2.0 (1.7 to 2.4) in women, consistently across population. Risk factors accounted for a third of inequalities in CHD incidence; smoking was the major mediator in men, and High-Density-Lipoprotein (HDL) cholesterol in women.Conclusions: Social inequalities in CHD are still widespread in Europe. Since the major determinants of inequalities followed geographical and gender-specific patterns, European-level interventions should be tailored across different European regions.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
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- art (subject category)
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Veronesi, Giovan ...
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Ferrario, Marco ...
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Kuulasmaa, Kari
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Bobak, Martin
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Chambless, Lloyd ...
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Salomaa, Veikko
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show more...
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Söderberg, Stefa ...
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Pajak, Andrzej
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Jorgensen, Torbe ...
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Amouyel, Philipp ...
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Arveiler, Domini ...
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Drygas, Wojciech
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Ferrieres, Jean
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Giampaoli, Simon ...
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Kee, Frank
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Iacoviello, Lici ...
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Malyutina, Sofia
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Peters, Annette
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Tamosiunas, Abdo ...
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Tunstall-Pedoe, ...
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Cesana, Giancarl ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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Heart
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Umeå University