ArticleBMC cardiovascular disorders2011
Do changes in traditional coronary heart disease risk factors over time explain the association between socio-economic status and coronary heart disease?
Article in BMC cardiovascular disorders, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 1 of them a synthesis that pooled it.
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Who cites it
39 citing papers in PubMed, 1 synthesis or guideline pooled it, 104 citations in OpenAlex.
- Allostatic Load and Cardiovascular Disease: A Systematic Review.American journal of preventive medicine · 2025Pooled it
- Trial
- Sex-specific associations of social determinants of health and genetic risk factors with atherosclerotic cardiovascular diseases incidence in the general population.American journal of preventive cardiology · 2026Article
- Neighborhood socioeconomic deprivation and physical activity associate with extracellular vesicle size and cargo in a community-based cohort of women.Scientific reports · 2026Article
- Multimorbidity as a driver of heart diseases risk among low socioeconomic older adults population in India.Scientific reports · 2025Article
- Disparities in the Use of Atherectomy and Intravascular Lithotripsy for Percutaneous Coronary Intervention.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Article
- High-dimensional mediation analysis for longitudinal mediators and survival outcomes.Briefings in bioinformatics · 2025Article
- Developing a Novel Index for Individual-Level Social Determinants and Cardiovascular Diseases in the Coronary Artery Risk Development in Young Adults (CARDIA) Study.International journal of environmental research and public health · 2025Article
- Differential effects of Mediterranean vs. Western diets on coronary atherosclerosis and peripheral artery transcriptomics.Frontiers in nutrition · 2025Article
- Behavioral risk factors and socioeconomic inequalities in ischemic heart disease mortality in the United States: A causal mediation analysis using record linkage data.PLoS medicine · 2024Article
- Refractive outcomes using Barrett formulas and patient characteristics of cataract surgery patients with and without prior LASIK/PRK.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2024Article
- Differential Associations of Alcohol Use With Ischemic Heart Disease Mortality by Socioeconomic Status in the US, 1997-2018.JAMA network open · 2024Article
- Influence of Socioeconomic Status on the Presence of Obstructive Coronary Artery Disease and Cardiovascular Outcomes in Patients Undergoing Invasive Coronary Angiography.Healthcare (Basel, Switzerland) · 2024Article
- The burden of premature coronary heart disease among adults with low socioeconomic status in Argentina: A modeling study.PloS one · 2024Article
- Associations between mercury exposure with blood pressure and lipid levels: A cross-sectional study of dental professionals.Environmental research · 2023Article
- Socioeconomic status may affect association of vegetable intake with risk of ischemic cardio-cerebral vascular disease: a Mendelian randomization study.Frontiers in nutrition · 2023Article
- The Interplay between Conventional Cardiovascular Risk Factors and Health-Related Quality of Life in a Cohort of Working Young and Middle-Aged Adults: A Prospective Study.Life (Basel, Switzerland) · 2022Article
- Article
- Promoting nurse-led behaviour change interventions to prevent cardiovascular disease in disadvantaged communities: A scoping review.Health & social care in the community · 2022Article
- Income level and outcomes in patients with heart failure with universal health coverage.Heart (British Cardiac Society) · 2021Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundSocioeconomic status (SES) predicts coronary heart disease independently of the traditional risk factors included in the Framingham risk score. However, it is unknown whether changes in Framingham risk score variables over time explain the association between SES and coronary heart disease. We examined this question given its relevance to risk assessment in clinical decision making.
methodsThe Atherosclerosis Risk in Communities study data (initiated in 1987 with 10-years follow-up of 15,495 adults aged 45-64 years in four Southern and Mid-Western communities) were used. SES was assessed at baseline, dichotomized as low SES (defined as low education and/or low income) or not. The time dependent variables - smoking, total and high density lipoprotein cholesterol, systolic blood pressure and use of blood pressure lowering medication - were assessed every three years. Ten-year incidence of coronary heart disease was based on EKG and cardiac enzyme criteria, or adjudicated death certificate data. Cox survival analyses examined the contribution of SES to heart disease risk independent of baseline Framingham risk score, without and with further adjustment for the time dependent variables.
resultsAdjusting for baseline Framingham risk score, low SES was associated with an increased coronary heart disease risk (hazard ratio [HR] = 1.53; 95% Confidence Interval [CI], 1.27 to 1.85). After further adjustment for the time dependent variables, the SES effect remained significant (HR = 1.44; 95% CI, 1.19 to 1.74).
conclusionUsing Framingham Risk Score alone under estimated the coronary heart disease risk in low SES persons. This bias was not eliminated by subsequent changes in Framingham risk score variables.
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