ArticleEuropean journal of epidemiology2013
Education and risk of coronary heart disease: assessment of mediation by behavioral risk factors using the additive hazards model.
Article in European journal of epidemiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- Associations of educational attainment and traditional risk factor control with cardiovascular disease.American journal of preventive cardiology · 2025Article
- Role of cardiovascular health factors in mediating social inequalities in the incidence of dementia in the UK: two prospective, population-based cohort studies.EClinicalMedicine · 2024Article
- Associations of educational attainment with Sepsis mediated by metabolism traits and smoking: a Mendelian randomization study.Frontiers in public health · 2024Article
- The effects of socioeconomic status on major adverse cardiovascular events: a nationwide population-based cohort study.Kidney research and clinical practice · 2023Article
- Association of educational attainment with esophageal cancer, Barrett's esophagus, and gastroesophageal reflux disease, and the mediating role of modifiable risk factors: A Mendelian randomization study.Frontiers in public health · 2023Article
- Epidemiological analysis of coronary heart disease and its main risk factors: are their associations multiplicative, additive, or interactive?Annals of medicine · 2022Article
- Projected New-Onset Cardiovascular Disease by Socioeconomic Group in Australia.PharmacoEconomics · 2022Article
- Educational disparities in ischaemic heart disease among 0.5 million Chinese adults: a cohort study.Journal of epidemiology and community health · 2021Article
- Observational
- Non-Persistence with Medication as a Mediator for the Social Inequality in Risk of Major Adverse Cardiovascular Events in Patients with Incident Acute Coronary Syndrome: A Nationwide Cohort Study.Clinical epidemiology · 2021Article
- Combined Effect of Marriage and Education on Mortality: A Cross-national Study of Older Japanese and Finnish Men and Women.Journal of epidemiology · 2020Article
- Homocysteine and education but not lipoprotein (a) predict estimated 10-year risk of cardiovascular disease in blood donors: a community based cross-sectional study.BMC cardiovascular disorders · 2019Article
- Education level and outcomes after acute myocardial infarction in China.Heart (British Cardiac Society) · 2019Article
- Understanding the consequences of education inequality on cardiovascular disease: mendelian randomisation study.BMJ (Clinical research ed.) · 2019Observational
- The association between education and cardiovascular disease incidence is mediated by hypertension, diabetes, and body mass index.Scientific reports · 2017Article
- Association of Educational Attainment With Lifetime Risk of Cardiovascular Disease: The Atherosclerosis Risk in Communities Study.JAMA internal medicine · 2017Article
- Quantification of Treatment Effect Modification on Both an Additive and Multiplicative Scale.PloS one · 2016Article
- Article
- The Rotterdam Study: 2016 objectives and design update.European journal of epidemiology · 2015Article
- The Generation R Study: Biobank update 2015.European journal of epidemiology · 2014Article
Corrections and comments
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- Erratum issued
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Educational-related gradients in coronary heart disease (CHD) and mediation by behavioral risk factors are plausible given previous research; however this has not been comprehensively addressed in absolute measures. Questionnaire data on health behavior of 69,513 participants, 52 % women, from seven Danish cohort studies were linked to registry data on education and incidence of CHD. Mediation by smoking, low physical activity, and body mass index (BMI) on the association between education and CHD were estimated by applying newly proposed methods for mediation based on the additive hazards model, and compared with results from the Cox proportional hazards model. Short (vs. long) education was associated with 277 (95 % CI: 219, 336) additional cases of CHD per 100,000 person-years at risk among women, and 461 (95 % CI: 368, 555) additional cases among men. Of these additional cases 17 (95 % CI: 12, 22) for women and 37 (95 % CI: 28, 46) for men could be ascribed to the pathway through smoking. Further, 39 (95 % CI: 30, 49) cases for women and 94 (95 % CI: 79, 110) cases for men could be ascribed to the pathway through BMI. The effects of low physical activity were negligible. Using contemporary methods, the additive hazards model, for mediation we indicated the absolute numbers of CHD cases prevented when modifying smoking and BMI. This study confirms previous claims based on the Cox proportional hazards model that behavioral risk factors partially mediates the effect of education on CHD, and the results seems not to be particularly model dependent.
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