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Roles of allostatic...
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Hicks, BlánaidCentre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
(author)
Roles of allostatic load, lifestyle and clinical risk factors in mediating the association between education and coronary heart disease risk in Europe
- Article/chapterEnglish2021
Publisher, publication year, extent ...
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2021-05-28
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BMJ Publishing Group Ltd,2021
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electronicrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:umu-184060
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-184060URI
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https://doi.org/10.1136/jech-2020-215394DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Background: Previous studies have shown that differential exposure to lifestyle factors may mediate the association between education and coronary heart diseases (CHD). However, few studies have examined the potential roles of allostatic load (AL) or differential susceptibility.Methods: 25 310 men and 26 018 women aged 35–74 and CHD free at baseline were identified from 21 European cohorts and followed for a median of 10 years, to investigate the mediating role of AL, as well as of smoking, alcohol use and body mass index (BMI), on educational differences in CHD incidence, applying marginal structural models and three-way decomposition.Results: AL is a mediator of the association between educational status and CHD incidence, with the highest proportion mediated observed among women and largely attributable to differential exposure, (28% (95% CI 19% to 44%)), with 8% (95% CI 0% to 16%) attributable to differential susceptibility. The mediating effects of smoking, alcohol and BMI, compared with AL, were relatively small for both men and women.Conclusion: Overall, the educational inequalities in CHD incidence were partially mediated through differential exposure to AL. By contrast, the mediation of the educational gradient in CHD by investigated lifestyle risk factors was limited. As differential susceptibility in men was found to have a predominant role in the accumulation of AL in low educational classes, the investigation of AL-related risk factors is warranted.
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Veronesi, GiovanniResearch Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
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Ferrario, Marco M.Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
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Forrest, HannahResearch Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
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Whitehead, MargaretDepartment of Public Health and Policy, Institute of Population Health and Sciences, University of Liverpool, Liverpool, United Kingdom
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Diderichsen, FinnDepartment of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Tunstall-Pedoe, HughCardiovascular Epidemiology Unit, Institute of Cardiovascular Research, University of Dundee, Dundee, United Kingdom
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Kuulasmaa, KariDepartment of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
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Sans, SusanaCatalan Department of Health, Barcelona, Spain
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Salomaa, VeikkoDepartment of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
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Thorand, BarbaraInstitute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
(author)
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Peters, AnnetteInstitute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; German Centre for Cardiovascular Research (DZHK), Partner site Munich Heart Alliance, Munich, Germany
(author)
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Söderberg, StefanUmeå universitet,Avdelningen för medicin(Swepub:umu)stso0001
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Cesana, GiancarloResearch Centre on Public Health, Department of Medicine and Surgery, University of Milan–Bicocca, Monza, Italy
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Bobak, MartinDepartment of Epidemiology and Public Health, University College London, London, United Kingdom
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Iacoviello, LiciaResearch Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
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Palmieri, LuigiDepartment of Cardiovascular, Endocrine-Metabolic Diseases, and Ageing, National Institute of Health, Roma, Lazio, Italy
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Zeller, TanjaDepartment of Cardiology, University Heart and Vascular Centre, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
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Blankenberg, StefanDepartment of Cardiology, University Heart and Vascular Centre, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
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Kee, FrankCentre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
(author)
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Centre for Public Health, Queen’s University Belfast, Belfast, United KingdomResearch Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
(creator_code:org_t)
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In:Journal of Epidemiology and Community Health: BMJ Publishing Group Ltd75:12, s. 1147-11540143-005X1470-2738
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