Research Article: Life course socioeconomic position, alcohol drinking patterns in midlife, and cardiovascular mortality: Analysis of Norwegian population-based health surveys

Date Published: January 2, 2018

Publisher: Public Library of Science

Author(s): Eirik Degerud, Inger Ariansen, Eivind Ystrom, Sidsel Graff-Iversen, Gudrun Høiseth, Jørg Mørland, George Davey Smith, Øyvind Næss, Jurgen Rehm

Abstract: BackgroundSocioeconomically disadvantaged groups tend to experience more harm from the same level of exposure to alcohol as advantaged groups. Alcohol has multiple biological effects on the cardiovascular system, both potentially harmful and protective. We investigated whether the diverging relationships between alcohol drinking patterns and cardiovascular disease (CVD) mortality differed by life course socioeconomic position (SEP).Methods and findingsFrom 3 cohorts (the Counties Studies, the Cohort of Norway, and the Age 40 Program, 1987–2003) containing data from population-based cardiovascular health surveys in Norway, we included participants with self-reported information on alcohol consumption frequency (n = 207,394) and binge drinking episodes (≥5 units per occasion, n = 32,616). We also used data from national registries obtained by linkage. Hazard ratio (HR) with 95% confidence intervals (CIs) for CVD mortality was estimated using Cox models, including alcohol, life course SEP, age, gender, smoking, physical activity, body mass index (BMI), systolic blood pressure, heart rate, triglycerides, diabetes, history of CVD, and family history of coronary heart disease (CHD). Analyses were performed in the overall sample and stratified by high, middle, and low strata of life course SEP. A total of 8,435 CVD deaths occurred during the mean 17 years of follow-up. Compared to infrequent consumption (

Partial Text: Socioeconomic position (SEP) is relevant to behaviours, exposures, and susceptibilities that may influence health [1], such as social support, financial resources, or the knowledge, awareness, and determination required to actively follow a healthy lifestyle or consult a physician if needed. There is an inverse socioeconomic gradient in the exposure to risk factors for cardiovascular diseases (CVDs) [2], which translates into a gradient in the risk of clinical CVD events [3,4]. The majority of heart attacks and strokes occur in late adulthood, but atherosclerosis development starts in childhood [5]. Socioeconomic disadvantage at different stages throughout the life course could therefore be relevant to risk factor exposure, atherosclerosis development, and the long-term risk of clinical cardiovascular events [6–10].



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