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    Socioeconomic status in relation to cardiovascular disease and causespecific mortality: A comparison of Asian and Australasian populations in a pooled analysis

    237601_237601.pdf (875.9Kb)
    Access Status
    Open access
    Authors
    Woodward, M.
    Peters, S.
    Batty, G.
    Ueshima, H.
    Woo, J.
    Giles, G.
    Barzi, F.
    Ho, S.
    Huxley, Rachel
    Arima, H.
    Fang, X.
    Dobson, A.
    Lam, T.
    Vathesatogkit, P.
    Date
    2015
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Woodward, M. and Peters, S. and Batty, G. and Ueshima, H. and Woo, J. and Giles, G. and Barzi, F. et al. 2015. Socioeconomic status in relation to cardiovascular disease and causespecific mortality: A comparison of Asian and Australasian populations in a pooled analysis. BMJ Open. 5 (3): pp. 1-10.
    Source Title
    BMJ Open
    DOI
    10.1136/bmjopen-2014-006408
    School
    School of Public Health
    Remarks

    This open access article is distributed under the Creative Commons license http://creativecommons.org/licenses/by-nc/4.0/

    URI
    http://hdl.handle.net/20.500.11937/14436
    Collection
    • Curtin Research Publications
    Abstract

    © 2015, BMJ. All rights reserved. Objectives: In Western countries, lower socioeconomic status is associated with a higher risk of cardiovascular disease (CVD) and premature mortality. These associations may plausibly differ in Asian populations, but data are scarce and direct comparisons between the two regions are lacking. We, thus, aimed to compare such associations between Asian and Western populations in a large collaborative study, using the highest level of education attained as our measure of social status. Setting: Cohort studies in general populations conducted in Asia or Australasia. Participants: 303 036 people (71% from Asia) from 24 studies in the Asia Pacific Cohort Studies Collaboration. Studies had to have a prospective cohort study design, have accumulated at least 5000 personyears of follow-up, recorded date of birth (or age), sex and blood pressure at baseline and date of, or age at, death during follow-up. Outcome measures: We used Cox regression models to estimate relationships between educational attainment and CVD (fatal or non-fatal), as well as allcause, cardiovascular and cancer mortality. Results: During more than two million person-years of follow-up, 11 065 deaths (3655 from CVD and 4313 from cancer) and 1809 CVD non-fatal events were recorded. Adjusting for classical CVD risk factors and alcohol drinking, hazard ratios (95% CIs) for primary relative to tertiary education in Asia (Australasia) were 1.81 (1.38, 2.36) (1.10 (0.99, 1.22)) for all-cause mortality, 2.47(1.47, 4.17) (1.24 (1.02, 1.51)) for CVD mortality, 1.66 (1.00, 2.78) (1.01 (0.87, 1.17)) for cancer mortality and 2.09 (1.34, 3.26) (1.23 (1.04, 1.46)) for all CVD. Conclusions: Lower educational attainment is associated with a higher risk of CVD or premature mortality in Asia, to a degree exceeding that in the Western populations of Australasia.

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