ArticleJournal of epidemiology and community health2021
Roles of allostatic load, lifestyle and clinical risk factors in mediating the association between education and coronary heart disease risk in Europe.
Article in Journal of epidemiology and community health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Allostatic Load and Cardiovascular Disease: A Systematic Review.American journal of preventive medicine · 2025Pooled it
- Social class and the risk of dementia: A systematic review and meta-analysis of the prospective longitudinal studies.Scandinavian journal of public health · 2023Pooled it
- Proteomic pathways mediating low socioeconomic status and cardiovascular events in older adults in CHS and ARIC.Atherosclerosis · 2026Article
- Article
- Factors influencing subjective well-being in individuals with functional dyspepsia - a path analysis of sex and psychological factors.Frontiers in medicine · 2026Article
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- Interventions to lower cardiovascular disease risk factors among Asian Indian immigrants: a scoping review protocol.BMJ open · 2025Article
- Socio-economic position and sudden cardiac death: a Danish nationwide study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Sex Differences in the Relationship of Socioeconomic Position With Cardiovascular Disease, Cardiovascular Risk Factors, and Estimated Cardiovascular Disease Risk: Results of the German National Cohort.Journal of the American Heart Association · 2025Article
- Article
- Resilience as Safety Culture in German Emergency Medical Services: Examining Irritation and Burnout.Healthcare (Basel, Switzerland) · 2024Article
- Neighborhood Socioeconomic Disadvantage and 30-Day Outcomes for Common Cardiovascular Conditions.Journal of the American Heart Association · 2024Article
- Exploring socioeconomic status, lifestyle factors, and cardiometabolic disease outcomes in the United States: insights from a population-based cross-sectional study.BMC public health · 2024Article
- Syndemics in women's health: poverty, social exclusion, and clustering of thrombotic and hemostasis disorders.Research and practice in thrombosis and haemostasis · 2024Article
- The gender and age perspectives of allostatic load.Frontiers in medicine · 2024Review
- Association between allostatic load and adverse outcomes among older patients with heart failure with preserved ejection fraction.BMC geriatrics · 2023Article
- Allostatic load and cardiovascular outcomes in males with prostate cancer.JNCI cancer spectrum · 2023Article
Corrections and comments
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Authors and funding
21 authors at 12 institutions in 7 countries.
Funding
Abstract
backgroundPrevious 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.
methods25 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.
resultsAL 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.
conclusionOverall, 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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