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Socioeconomic status, education, and aortic stiffness progression over 5 years: the Whitehall II prospective cohort study

Trudel, X; Shipley, MJ; McEniery, CM; Wilkinson, IB; Brunner, EJ; (2016) Socioeconomic status, education, and aortic stiffness progression over 5 years: the Whitehall II prospective cohort study. Journal of Hypertension , 34 (10) pp. 2038-2044. 10.1097/HJH.0000000000001057. Green open access

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Abstract

OBJECTIVE: The inverse association between socioeconomic status (SES) and cardiovascular disease (CVD) risk is well documented. Aortic stiffness assessed by aortic pulse wave velocity (PWV) is a strong predictor of CVD events. However, no previous study has examined the effect of SES on arterial stiffening over time. The present study examines this association, using several measures of SES, and attained education level in a large ageing cohort of British men and women. METHODS: Participants were drawn from the Whitehall II study. The sample was composed of 3836 men and 1406 women who attended the 2008-2009 clinical examination (mean age = 65.5 years). Aortic PWV was measured in 2008-2009 and in 2012-2013 by applanation tonometry. A total of 3484 participants provided PWV measurements on both occasions. The mean difference in 5-year PWV change was examined according to household income, education, employment grade, and father's social class, using linear mixed models. RESULTS: PWV increase [mean: confidence interval (m/s)] over 5 years was higher among participants with lower employment grade (0.38: 0.11-0.65), household income (0.58, 95%: 0.32-0.85), and education (0.30: 0.01, 0.58), after adjusting for sociodemographic variables, BMI, alcohol consumption, smoking, and other cardiovascular risk factors, namely SBP, mean arterial pressure, heart rate, cholesterol, diabetes, and antihypertensive use. CONCLUSION: The present study supports the presence of robust socioeconomic disparities in aortic stiffness progression. Our findings suggest that arterial aging could be an important pathophysiological pathway explaining the impact of lower SES on CVD risk.

Type: Article
Title: Socioeconomic status, education, and aortic stiffness progression over 5 years: the Whitehall II prospective cohort study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/HJH.0000000000001057
Publisher version: http://dx.doi.org/10.1097/HJH.0000000000001057
Language: English
Additional information: This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/1512891
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