ArticleBMC public health2015
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.
Article in BMC public health, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Are socio-economic inequalities related to cardiovascular disease risk? A systematic review and meta-analysis of prospective studies.BMC cardiovascular disorders · 2024Pooled it
- State-Level Structural Racism and Incident Coronary Heart Disease.Journal of the American Heart Association · 2026Article
- Income, education, and the clustering of risk in cardiovascular disease in the US, 1999-2018: an observational study.Lancet regional health. Americas · 2025Article
- Social determinants of health and health outcomes in older cancer survivors.Current opinion in supportive and palliative care · 2025Review
- Associations of Self-Reported Race, Social Determinants of Health, and Polygenic Risk With Coronary Heart Disease.Journal of the American College of Cardiology · 2024Article
- Decrease in Socioeconomic Disparities in Self-Rated Oral Health among Brazilian Adults between 2013 and 2019: Results from the National Health Survey.International journal of environmental research and public health · 2024Article
- Circulating Metabolite Profiles and Risk of Coronary Heart Disease Among Racially and Geographically Diverse Populations.Circulation. Genomic and precision medicine · 2024Article
- Socioeconomic status as a potential mediator of arterial aging in marginalized ethnic and racial groups: current understandings and future directions.Journal of applied physiology (Bethesda, Md. : 1985) · 2024Review
- The burden of premature coronary heart disease among adults with low socioeconomic status in Argentina: A modeling study.PloS one · 2024Article
- A comprehensive analysis of cardiovascular mortality trends in Peru from 2017 to 2022: Insights from 183,386 deaths of the national death registry.American heart journal plus : cardiology research and practice · 2023Article
- Association of Socioeconomic Status With Outcomes and Care Quality in Patients Presenting With Undifferentiated Chest Pain in the Setting of Universal Health Care Coverage.Journal of the American Heart Association · 2022Article
- Multiple Social Vulnerabilities to Health Disparities and Hypertension and Death in the REGARDS Study.Hypertension (Dallas, Tex. : 1979) · 2022Article
- Does a physical activity supportive environment ameliorate or exacerbate socioeconomic inequities in incident coronary heart disease?Journal of epidemiology and community health · 2021Article
- Number of Social Determinants of Health and Fatal and Nonfatal Incident Coronary Heart Disease in the REGARDS Study.Circulation · 2021Observational
- Trends in Cardiovascular Disease Prevalence by Income Level in the United States.JAMA network open · 2020Article
- Article
- Low Educational Attainment is a Predictor of Adverse Outcomes in Patients With Coronary Artery Disease.Journal of the American Heart Association · 2019Article
- A PheWAS study of a large observational epidemiological cohort of African Americans from the REGARDS study.BMC medical genomics · 2019Article
- Review
- Effects of Concurrent Depressive Symptoms and Perceived Stress on Cardiovascular Risk in Low- and High-Income Participants: Findings From the Reasons for Geographical and Racial Differences in Stroke (REGARDS) Study.Journal of the American Heart Association · 2016Observational
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundWe investigated the association between income-education groups and incident coronary heart disease (CHD) in a national prospective cohort study.
methodsThe 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 <$35,000)/low education (< 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.
resultsAt 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 <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.
conclusionFor 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.
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