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Stannard S, Berrington A, Alwan NA. The mediating pathways between parental separation in childhood and offspring hypertension at midlife. Sci Rep 2022; 12:7062. [PMID: 35488035 PMCID: PMC9054745 DOI: 10.1038/s41598-022-11007-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 04/15/2022] [Indexed: 11/12/2022] Open
Abstract
Social life course determinants of adult hypertension are relatively unknown. This paper examines how parental separation before age 10 relates to hypertension at age 46. Adjusting for parental confounders and considering the role of adult mediators, we aim to quantify unexplored mediating pathways in childhood using prospectively collected data. Data from the 1970 British Birth Cohort Study are utilised. Hypertension is measured by health care professionals at age 46. Potential mediating pathways in childhood include body mass index (BMI), systolic and diastolic blood pressure, illness, disability, family socioeconomic status (SES) and cognitive and developmental indicators at age 10. Additionally, we explore to what extent childhood mediators operate through adult mediators, including health behaviours, family SES, BMI and mental wellbeing. We also test for effect modification of the relationship between parental separation and hypertension by gender. Nested logistic regression models test the significance of potential mediating variables. Formal mediation analysis utilising Karlson Holm and Breen (KHB) method quantify the direct and indirect effect of parental separation on offspring hypertension at midlife. There was an association between parental separation and hypertension in mid-life in women but not men. For women, family SES and cognitive and behavioural development indicators at age 10 partly mediate the relationship between parental separation and hypertension at age 46. When adult mediators including, health behaviours, family SES, BMI and mental wellbeing are included, the associations between the childhood predictors and adult hypertension are attenuated, suggesting that these childhood mediators in turn may work through adult mediators to affect the risk of hypertension in midlife. We found family SES in childhood, cognitive and behaviour development indicators at age 10, including disruptive behaviour, coordination and locus of control in childhood, to be important mediators of the relationship between parental separation and midlife hypertension suggesting that intervening in childhood may modify adult hypertension risk.
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Affiliation(s)
- Sebastian Stannard
- Department of Social Statistics and Demography, University of Southampton, Building 58, University Road, Southampton, SO17 1BJ, UK. .,ESRC Centre for Population Change, University of Southampton, Southampton, UK.
| | - Ann Berrington
- Department of Social Statistics and Demography, University of Southampton, Building 58, University Road, Southampton, SO17 1BJ, UK.,ESRC Centre for Population Change, University of Southampton, Southampton, UK
| | - Nisreen A Alwan
- School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.,NIHR Applied Research Collaboration Wessex, Southampton, UK
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Patel A, Bharani A, Sharma M, Bhagwat A, Ganguli N, Chouhan DS. Prevalence of hypertension and prehypertension in schoolchildren from Central India. Ann Pediatr Cardiol 2019; 12:90-96. [PMID: 31143032 PMCID: PMC6521652 DOI: 10.4103/apc.apc_13_18] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background: Epidemiological transition with increasing burden of cardiovascular risk factors is evident not only in adults but also in children. The data on the prevalence of prehypertension and hypertension in children show large regional differences in India and such data are not available from Central India. We, therefore, conducted a large cross-sectional study in Indore to determine the distribution of blood pressure (BP) and the prevalence of hypertension and prehypertension among schoolchildren. Methods: A total of 11,312 children (5305 girls, 6007 boys) aged 5–15 years, drawn from 80 government and private schools in equal proportion, were evaluated. Anthropometric measurements were obtained and BPs were measured using The Fourth Report on The Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents as reference standard. BP ≥90th to <95th percentile for given percentile of height was considered as prehypertension, whereas any BP ≥95th percentile was defined as hypertension. Multiple linear regression analysis was used to find out the determinants of hypertension in these children. Results: Prehypertension was detected in 6.9% and 6.5% and hypertension was found in 6.8% and 7.0% of boys and girls, respectively. Height and weight were found to be a significant predictor of systolic and diastolic BP among both boys and girls. Conclusions: Our results show a high prevalence of prehypertension and hypertension in Indore schoolchildren with age and height being significant determinants. This highlights the need for routine BP measurements in children by pediatricians when they treat them for intercurrent illnesses or vaccinate them. It should also be mandatory as a part of school health checkup programs to detect childhood hypertension for further counseling and therapy.
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Affiliation(s)
- Ashish Patel
- Department of Medicine, MGM Medical College, Indore, Madhya Pradesh, India
| | - Anil Bharani
- Department of Medicine, MGM Medical College, Indore, Madhya Pradesh, India
| | - Meenakshi Sharma
- Scientist 'F', Division of Noncommunicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Anuradha Bhagwat
- JVMM Project on Community Control of Rheumatic Fever/Rheumatic Heart Disease, Rheumatic Fever/Rheumatic Heart Disease Registry, Indore, Madhya Pradesh, India
| | - Neepa Ganguli
- JVMM Project on Community Control of Rheumatic Fever/Rheumatic Heart Disease, Rheumatic Fever/Rheumatic Heart Disease Registry, Indore, Madhya Pradesh, India
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Kagura J, Adair LS, Pisa PT, Griffiths PL, Pettifor JM, Norris SA. Association of socioeconomic status change between infancy and adolescence, and blood pressure, in South African young adults: Birth to Twenty Cohort. BMJ Open 2016; 6:e008805. [PMID: 27029771 PMCID: PMC4823398 DOI: 10.1136/bmjopen-2015-008805] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Social epidemiology models suggest that socioeconomic status (SES) mobility across the life course affects blood pressure. The aim of this study was to investigate the association between SES change between infancy and adolescence, and blood pressure, in young adults, and the impact of early growth on this relationship. SETTING Data for this study were obtained from a 'Birth to Twenty' cohort in Soweto, Johannesburg, in South Africa. PARTICIPANTS The study included 838 Black participants aged 18 years who had household SES measures in infancy and at adolescence, anthropometry at 0, 2, 4 and 18 years of age and blood pressure at the age of 18 years. METHODS We computed SES change using asset-based household SES in infancy and during adolescence as an exposure variable, and blood pressure and hypertension status as outcomes. Multivariate linear and logistic regressions were used to investigate the associations between SES change from infancy to adolescence, and age, height and sex-specific blood pressure and hypertension prevalence after adjusting for confounders. RESULTS Compared to a persistent low SES, an upward SES change from low to high SES tertile between infancy and adolescence was significantly associated with lower systolic blood pressure (SBP) at the age of 18 years (β=-4.85; 95% CI -8.22 to -1.48; p<0.01; r(2)=0.1804) after adjusting for SES in infancy, small-for-gestational-age (SGA) and weight gain. Associations between SES change and SBP were partly explained by weight gain between birth and the age of 18 years. There was no association between SES mobility and diastolic blood pressure, mean arterial pressure or hypertension status. CONCLUSIONS Our study confirms that upward SES change has a protective effect on SBP by the time participants reach young adulthood. Socioeconomic policies and interventions that address inequality may have the potential to reduce cardiovascular disease burden related to BP in later life.
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Affiliation(s)
- Juliana Kagura
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Linda S Adair
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
- Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Pedro T Pisa
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Paula L Griffiths
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
- Centre for Global Health and Human Development, School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
| | - John M Pettifor
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Shane A Norris
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
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Strasser S, Smith MO, Pendrick Denney D, Jackson MC, Buckmaster P. A Poverty Simulation to Inform Public Health Practice. AMERICAN JOURNAL OF HEALTH EDUCATION 2013. [DOI: 10.1080/19325037.2013.811366] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Janicki-Deverts D, Cohen S, Matthews KA, Jacobs DR. Sex differences in the association of childhood socioeconomic status with adult blood pressure change: the CARDIA study. Psychosom Med 2012; 74:728-35. [PMID: 22822232 PMCID: PMC3434230 DOI: 10.1097/psy.0b013e31825e32e8] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine sex differences in the relation of childhood socioeconomic status (CSES) to systolic (SBP) and diastolic blood pressure (DBP) trajectories during 15 years, spanning young (mean [M] [standard deviation {SD}] = 30 [3] years) and middle (M [SD] = 45 [3] years) adulthood, independent of adult SES. METHODS A total of 4077 adult participants reported father's and mother's educational attainments at study enrollment (Year 0) and own educational attainment at enrollment and at all follow-up examinations. Resting BP also was measured at all examinations. Data from examination Years 5 (when participant M [SD] age = 30 [3] years), 7, 10, 15, and 20 are examined here. Associations of own adult (Year 5), mother's, and father's educations with 15-year BP trajectories were examined in separate multilevel models. Fully controlled models included time-invariant covariates (age, sex, race, recruitment center) and time-varying covariates that were measured at each examination (marital status, body mass, cholesterol, oral contraceptives/hormones, and antihypertensive drugs). Analyses of parental education controlled for own education. RESULTS When examined without covariates, higher education - own (SBP γ = -0.03, DBP γ = -0.03), mother's (SBP γ = -0.02, DBP γ = -0.02), and father's (SBP γ = -0.02, DBP γ = -0.01) - were associated with attenuated 15-year increases in BP (p < .001). Associations of own (but not either parent's) education with BP trajectories remained independent of standard controls. Sex moderated the apparent null effects of parental education, such that higher parental education-especially mother's, predicted attenuated BP trajectories independent of standard covariates among women (SBP γ = -0.02, p = .02; DBP γ = -0.01, p = .04) but not men (SBP γ = 0.02, p = .06; DBP γ = 0.005, p = .47; p interaction SBP < .001, p interaction DBP = .01). CONCLUSIONS Childhood socioeconomic status may influence women's health independent of their own adult status.
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Affiliation(s)
| | - Sheldon Cohen
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213
| | - Karen A. Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213
| | - David R. Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455, also affiliated with the Department of Nutrition, University of Oslo, Oslo, Norway
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Wang Y, Guo J, Lu W, Li Y, Wang J, Wan Z. Association of modifiable lifestyle behaviors with hypertension by various body mass index categories in Tianjin province of China: a cross-sectional study. Asia Pac J Public Health 2012; 27:NP266-77. [PMID: 22426555 DOI: 10.1177/1010539512439227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The present study was conducted to identify the difference of the relationship between lifestyle behaviors with hypertension (HTN) by various body mass index (BMI) categories. A cross-sectional study was conducted among Tianjin urban communities. A total of 26 438 subjects were randomly selected. The authors evaluated associations of lifestyle behaviors with HTN among normal, overweight, and obese adults using a hierarchical logistic model considering the gross domestic product of residence as socioeconomic proxy. A positive association was found between BMI and the risk of HTN among male and female subjects. Current smoking was associated with a higher risk of HTN in overweight (odds ratio [OR] = 1.19, 95% confidence interval [CI] = 1.04-1.36) and obese groups (OR = 1.20, 95% CI = 1.03-1.53). There were statistically significant associations of current drinking with risk of HTN in normal weight (OR = 1.18, 95% CI = 1.01-1.31) and overweight groups (OR = 1.22, 95% CI = 1.07-1.40). The prevention of overweight and obesity is important in preventing HTN. Additionally, adherence to healthy lifestyle is associated with less risk of HTN in various BMI categories.
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Affiliation(s)
- Yuan Wang
- Department of Health Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jian Guo
- Tianjin Tanggu Center for Disease Control and Prevention, Tianjin, China
| | - Wenli Lu
- Department of Health Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - YongLe Li
- Tianjin Medical University General Hospital, Tianjin, China
| | - JianHua Wang
- Department of Health Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zheng Wan
- Tianjin Medical University General Hospital, Tianjin, China
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Kestilä P, Magnussen CG, Viikari JS, Kähönen M, Hutri-Kähönen N, Taittonen L, Jula A, Loo BM, Pietikäinen M, Jokinen E, Lehtimäki T, Kivimäki M, Juonala M, Raitakari OT. Socioeconomic Status, Cardiovascular Risk Factors, and Subclinical Atherosclerosis in Young Adults. Arterioscler Thromb Vasc Biol 2012; 32:815-21. [DOI: 10.1161/atvbaha.111.241182] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Paula Kestilä
- From the Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (P.K., C.G.M., M.J., O.T.R.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Medicine (J.S.A.V., M.J.) and Clinical Physiology (O.T.R.), Turku University Hospital, Turku, Finland; Departments of Clinical Physiology (M. Kähönen) and Clinical Chemistry (T.L.), University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Costan G. Magnussen
- From the Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (P.K., C.G.M., M.J., O.T.R.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Medicine (J.S.A.V., M.J.) and Clinical Physiology (O.T.R.), Turku University Hospital, Turku, Finland; Departments of Clinical Physiology (M. Kähönen) and Clinical Chemistry (T.L.), University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Jorma S.A. Viikari
- From the Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (P.K., C.G.M., M.J., O.T.R.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Medicine (J.S.A.V., M.J.) and Clinical Physiology (O.T.R.), Turku University Hospital, Turku, Finland; Departments of Clinical Physiology (M. Kähönen) and Clinical Chemistry (T.L.), University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Mika Kähönen
- From the Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (P.K., C.G.M., M.J., O.T.R.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Medicine (J.S.A.V., M.J.) and Clinical Physiology (O.T.R.), Turku University Hospital, Turku, Finland; Departments of Clinical Physiology (M. Kähönen) and Clinical Chemistry (T.L.), University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Nina Hutri-Kähönen
- From the Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (P.K., C.G.M., M.J., O.T.R.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Medicine (J.S.A.V., M.J.) and Clinical Physiology (O.T.R.), Turku University Hospital, Turku, Finland; Departments of Clinical Physiology (M. Kähönen) and Clinical Chemistry (T.L.), University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Leena Taittonen
- From the Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (P.K., C.G.M., M.J., O.T.R.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Medicine (J.S.A.V., M.J.) and Clinical Physiology (O.T.R.), Turku University Hospital, Turku, Finland; Departments of Clinical Physiology (M. Kähönen) and Clinical Chemistry (T.L.), University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Antti Jula
- From the Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (P.K., C.G.M., M.J., O.T.R.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Medicine (J.S.A.V., M.J.) and Clinical Physiology (O.T.R.), Turku University Hospital, Turku, Finland; Departments of Clinical Physiology (M. Kähönen) and Clinical Chemistry (T.L.), University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Britt-Marie Loo
- From the Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (P.K., C.G.M., M.J., O.T.R.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Medicine (J.S.A.V., M.J.) and Clinical Physiology (O.T.R.), Turku University Hospital, Turku, Finland; Departments of Clinical Physiology (M. Kähönen) and Clinical Chemistry (T.L.), University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Matti Pietikäinen
- From the Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (P.K., C.G.M., M.J., O.T.R.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Medicine (J.S.A.V., M.J.) and Clinical Physiology (O.T.R.), Turku University Hospital, Turku, Finland; Departments of Clinical Physiology (M. Kähönen) and Clinical Chemistry (T.L.), University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Eero Jokinen
- From the Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (P.K., C.G.M., M.J., O.T.R.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Medicine (J.S.A.V., M.J.) and Clinical Physiology (O.T.R.), Turku University Hospital, Turku, Finland; Departments of Clinical Physiology (M. Kähönen) and Clinical Chemistry (T.L.), University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Terho Lehtimäki
- From the Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (P.K., C.G.M., M.J., O.T.R.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Medicine (J.S.A.V., M.J.) and Clinical Physiology (O.T.R.), Turku University Hospital, Turku, Finland; Departments of Clinical Physiology (M. Kähönen) and Clinical Chemistry (T.L.), University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Mika Kivimäki
- From the Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (P.K., C.G.M., M.J., O.T.R.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Medicine (J.S.A.V., M.J.) and Clinical Physiology (O.T.R.), Turku University Hospital, Turku, Finland; Departments of Clinical Physiology (M. Kähönen) and Clinical Chemistry (T.L.), University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Markus Juonala
- From the Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (P.K., C.G.M., M.J., O.T.R.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Medicine (J.S.A.V., M.J.) and Clinical Physiology (O.T.R.), Turku University Hospital, Turku, Finland; Departments of Clinical Physiology (M. Kähönen) and Clinical Chemistry (T.L.), University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Olli T. Raitakari
- From the Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (P.K., C.G.M., M.J., O.T.R.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Medicine (J.S.A.V., M.J.) and Clinical Physiology (O.T.R.), Turku University Hospital, Turku, Finland; Departments of Clinical Physiology (M. Kähönen) and Clinical Chemistry (T.L.), University of Tampere and Tampere University Hospital, Tampere, Finland
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Schreier HMC, Chen E. Socioeconomic status in one's childhood predicts offspring cardiovascular risk. Brain Behav Immun 2010; 24:1324-31. [PMID: 20600814 DOI: 10.1016/j.bbi.2010.06.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 06/04/2010] [Accepted: 06/15/2010] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To test whether effects of socioeconomic environments can persist across generations, we examined whether parents' childhood socioeconomic status (SES) could predict blood pressure (BP) trajectories in their youth across a 12-month study period and C-reactive protein (CRP) levels at one year follow-up. METHODS BP was assessed in 88 healthy youth (M age = 13 ± 2.4) at three study visits, each 6 months apart. CRP was also assessed in youth at baseline and one year follow-up. Parents reported on current and their own childhood SES (education and crowding). RESULTS If parents' childhood SES was lower, their children displayed increasing SBP and CRP over the 12-month period, or conversely, the higher parents' childhood SES, the greater the decrease in SBP and CRP in their youth over time. These effects persisted even after controlling for current SES. A number of other factors, including child health behaviors, parent psychosocial characteristics, general family functioning, and parent physiology could not explain these effects. CONCLUSION Our study suggests that the SES environment parents grow up in may influence physical health across generations, here, SBP and CRP in their children, and hence that intergenerational histories are important to consider in predicting cardiovascular health in youth.
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Affiliation(s)
- Hannah M C Schreier
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada.
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Mauno S, Feldt T, Tolvanen A, Hyvönen K, Kinnunen U. Prospective relationships between career disruptions and subjective well-being: evidence from a three-wave follow-up study among Finnish managers. Int Arch Occup Environ Health 2010; 84:501-12. [PMID: 20938675 DOI: 10.1007/s00420-010-0583-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Accepted: 09/27/2010] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objective of this study was to examine the prospective relationships between career disruptions and subjective well-being by using a three-way follow-up data with a 10-year time lag. Specifically, we investigated the causation and selection hypotheses by examining the directions of causal associations between career disruptions and subjective well-being. The causation hypothesis states that negative career changes will result in poorer well-being, whereas the selection hypothesis expects this linkage to be vice versa, that is, employees' well-being impacts their career line. METHODS The sample consisted of Finnish managers (n = 528) who participated in this questionnaire study 3 times: in 1996 (T1), 1999 (T2), and 2006 (T3). Career disruptions covered the periods of unemployment, layoffs, and redundancies. Subjective well-being was assessed with sense of coherence (SOC) and psychosomatic symptoms (PSS). The causation versus selection hypotheses were tested with Structural Equation Modeling using a full-panel design, that is, the variables of career disruptions, SOC, and PSS were measured in each wave. RESULTS Support was found for both the causation and selection hypotheses. First, career disruptions experienced before T1 predicted increased PSS at T1, providing support for the causation hypothesis. Second, low SOC in T2 predicted subsequent career disruptions 7 years later at T3, supporting the selection hypothesis. Furthermore, SOC and PSS showed high stability over time, whereas career disruptions accumulated over time: those who reported career disruptions at T1 had a higher risk to experience disruptions also at T2 and T3. CONCLUSIONS Negative career changes seem to associate with low subjective well-being (PSS) on short term and, in turn, low subjective well-being (SOC) seems to associate with negative career changes on long term among managers. The different results depending on the well-being measure might relate to the conceptual differences between the well-being indicators used (PSS, SOC) and the different time frame needed for causation and selection. Thus, in examining the causation versus selection hypotheses, it is important to evaluate subjective well-being using different indicators and time lags. Managers may benefit from interventions targeting to enhance their mental resilience and employability in the cases of negative career changes.
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Affiliation(s)
- Saija Mauno
- Department of Psychology, University of Jyväskylä, P. O. Box 35, 40014 Jyväskylä, Finland.
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Abstract
Hypertension is a major cause of disease burden in all racial, ethnic, and socioeconomic groups in developing and developed regions and countries. Differences in blood pressure likely begin early in life and reflect a complex relationship of biologic, genetic, social, and environmental interactions. The relationship between socioeconomic status and hypertension is complex and difficult to measure. Instituting lifestyle changes for the primary prevention and treatment of hypertension among the general population would decrease prevalence, improve blood pressure control, and be effective in eliminating many socioeconomic differences in risk factors for cardiovascular disease. Health care providers can potentially impact blood pressure control by incorporating knowledge of socioeconomic factors and mechanisms in care delivery. This review highlights socioeconomic status in the prevalence and incidence of hypertension and identifies contributing factors associated with blood pressure control.
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Hossain MP, Goyder EC, Rigby JE, El Nahas M. CKD and poverty: a growing global challenge. Am J Kidney Dis 2009; 53:166-74. [PMID: 19101400 DOI: 10.1053/j.ajkd.2007.10.047] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2008] [Accepted: 10/16/2008] [Indexed: 11/11/2022]
Abstract
Approximately 1.2 billion individuals worldwide live in extreme poverty (< $1/d), and 2.7 billion live in moderate poverty (< $2/d). Poverty is most prevalent in developing countries, but does not spare richer economies, where huge income discrepancies have been reported. Poverty is a major health care marker affecting a number of chronic, communicable, and noncommunicable diseases. Poverty and social deprivation are known to affect the predisposition, diagnosis, and management of chronic diseases; they directly impact on the prevalence of such conditions as obesity, diabetes, and hypertension. Also, growing evidence links poverty to chronic kidney disease (CKD). This may be caused by a direct impact of poverty on CKD or indirectly through the increased health care burden linked to poverty-associated diabetes and hypertension. Furthermore, data have shown that the poor and socially deprived have a greater prevalence of end-stage renal disease. Access to renal care, dialysis, and transplantation may also be affected by social deprivation. Overall, poverty and social deprivation are emerging as major risk markers for CKD in both developing and developed countries. Their impact on CKD warrants careful analysis because it may confound the interpretation of CKD risk factors within communities. This review therefore aims to look at the evidence linking poverty to CKD and its major risk factors, namely, diabetes and hypertension.
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Affiliation(s)
- Mohammed P Hossain
- Sheffield Kidney Institute, University of Sheffield, Herries Road, Sheffield, UK
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13
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Abstract
OBJECTIVE To investigate the potential for gene x environment interaction in hypertension by examining the extent to which educational attainment modifies the heritability of hypertension in male twins. Prior twin and family studies have established that hypertension runs in families and is heritable. In addition, epidemiological research indicates that the prevalence of hypertension differs by socioeconomic factors, such as educational attainment. METHODS Twin structural equation modeling was used to examine educational attainment as a moderator of heritability of hypertension. Participants were 4301 monozygotic and 3414 dizygotic male Vietnam-era twins who provided data on both education (in years) and self-report of physician diagnosis of hypertension or medication usage. RESULTS Heritability was 17 points lower among co-twins concordant for educational attainment of < or =14 years (0.46, 95% CI = 0.32-0.57) relative to co-twins concordant for >14 years of education (0.63, 95% CI = 0.54-0.71). The significant moderation of the heritability (p = .04) was confirmed in twin models examining educational attainment as a continuous moderator of hypertension. CONCLUSIONS These results demonstrate that the expression of genetic vulnerability to hypertension can vary as a function of environmental factors, including education level, and that nongenetic pathways may differentially contribute to risk among those with fewer years of education.
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14
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Pitkänen T, Kokko K, Lyyra AL, Pulkkinen L. A developmental approach to alcohol drinking behaviour in adulthood: a follow-up study from age 8 to age 42. Addiction 2008; 103 Suppl 1:48-68. [PMID: 18426540 DOI: 10.1111/j.1360-0443.2008.02176.x] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To study the links of family background, child and adolescent social behaviour, and (mal)adaptation with heavy drinking by age 20 and with the frequency of drinking, binge drinking, Cut-down, Annoyed, Guilt, Eye-opener (CAGE) questionnaire scores and problems due to drinking at ages 27 and 42 years. DESIGN In the Finnish Jyväskylä Longitudinal Study of Personality and Social Development, data have been collected by interviews, inventories and questionnaires. Behavioural data were gathered at ages 8 and 14; data on alcohol consumption were gathered at ages 14, 20, 27, 36 and 42. PARTICIPANTS A total of 184 males and 163 females; 94% of the original sample of the 8-year-olds. FINDINGS Family adversities, externalizing problem behaviours, low school success, truancy and substance use in adolescence were associated in early middle age with problems due to drinking in both genders, and to binge drinking and CAGE scores in females. The antecedents varied, however, across the indicators of drinking and gender. The frequency of drinking was least predictable by the studied antecedents. Childhood and adolescent antecedents and drinking up to age 20 explained 43% of males' and 31% of females' problem drinking at age 42; 31% and 19%, respectively, at age 27. CONCLUSIONS The early warning signs of drinking problems should be taken seriously in the preventive work for alcohol abuse. Problem drinking in early middle age is preceded by maladjustment to school, early age of onset of drinking and heavy drinking in adolescence even more significantly than problem drinking in early adulthood.
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Affiliation(s)
- Tuuli Pitkänen
- Department of Psychology, University of Jyväskylä, Finland.
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15
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Chen X, Wang Y, Appel LJ, Mi J. Impacts of Measurement Protocols on Blood Pressure Tracking From Childhood Into Adulthood. Hypertension 2008; 51:642-9. [DOI: 10.1161/hypertensionaha.107.102145] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The best approach for blood pressure (BP) measurement in children remains controversial, specifically regarding the choice of Korotkoff phase 4 versus Korotkoff phase 5 for diastolic BP (DBP) and the use of automated devices. To examine the impacts of different BP measurement protocols on BP tracking from childhood into adulthood, we conducted a meta-analysis of 50 related studies published between 1970 and 2006 identified based on a systematic search of PubMed. These studies provided 617 data points (tracking correlation coefficient, our outcome variable) for systolic BP and 547 data points for DBP for our meta-analysis. The explanatory variables included the use of Korotkoff phase 4/Korotkoff phase 5, BP device, and number of BP measurements per visit. Analyses were adjusted for potential confounders, including sex, baseline age, follow-up length, publication year, and study country. Tracking correlation coefficients for DBP measured using Korotkoff phase 4 was higher than that of Korotkoff phase 5 by 0.035 but not significant. DBP tracking assessed by automated device was higher than that of Korotkoff phase 5 by 0.152 (
P
=0.024) and higher than the mercury manometer by 0.223 (
P
=0.005). BP tracking was slightly higher with multiple BP measurements per visit, but measurements of ≥3 times did not improve the tracking further compared with 2 measurements. Although policy-making bodies currently recommend the use of Korotkoff phase 5 to assess DBP in children, our metaregression analysis did not support the recommendation. In general, Korotkoff phase 4 seems to be different from Korotkoff phase 5, and automated device is a promising approach for BP assessment in childhood.
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Affiliation(s)
- Xiaoli Chen
- From the Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health (X.C., Y.W.), and Welch Center for Prevention, Epidemiology, and Clinical Research (L.J.A.), Johns Hopkins University, Baltimore, Md; and the Department of Epidemiology (J.M.), Capital Institute of Pediatrics, Beijing, China
| | - Youfa Wang
- From the Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health (X.C., Y.W.), and Welch Center for Prevention, Epidemiology, and Clinical Research (L.J.A.), Johns Hopkins University, Baltimore, Md; and the Department of Epidemiology (J.M.), Capital Institute of Pediatrics, Beijing, China
| | - Lawrence J. Appel
- From the Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health (X.C., Y.W.), and Welch Center for Prevention, Epidemiology, and Clinical Research (L.J.A.), Johns Hopkins University, Baltimore, Md; and the Department of Epidemiology (J.M.), Capital Institute of Pediatrics, Beijing, China
| | - Jie Mi
- From the Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health (X.C., Y.W.), and Welch Center for Prevention, Epidemiology, and Clinical Research (L.J.A.), Johns Hopkins University, Baltimore, Md; and the Department of Epidemiology (J.M.), Capital Institute of Pediatrics, Beijing, China
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16
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Littrell J. New developments in understanding cardiovascular disease and the implications for social work. SOCIAL WORK IN HEALTH CARE 2008; 46:35-49. [PMID: 18192196 DOI: 10.1300/j010v46n02_03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Cardiovascular disease is now viewed as an inflammatory disease. An index of chronic inflammation (viz., C-Reactive Protein) is as good a predictor of heart attacks as are fats in blood. The data suggest that stressful events are so closely associated with chronic inflammatory states, that the body's stress response can be viewed as an inflammatory state. This paper summarizes and explains the link between stress and cardiovascular disease. Negative health outcomes, particularly for cardiovascular diseases, are higher among those of lower socio-economic status. Differential stress among socio-economic tiers is considered as an explanation for the disparities. The literature linking cardiovascular risk factors to the stressors of workplace unfairness and lack of control over working conditions is reviewed. The role of the stressor of racism in explaining the higher rates of cardiovascular mortality in African Americans is discussed. Finally, for societies with wider gaps in income between the rich and the poor, increased stress is explored as a possible explanation for the diminished health outcomes found across all socio-economic tiers. The implications for social work direct practice and macro-practice are considered.
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Affiliation(s)
- Jill Littrell
- Georgia State University, 585 Indian Acres Court, Tucker, GA 30084, USA.
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17
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Min JW, Kong KA, Park BH, Hong JH, Park EA, Cho SJ, Ha EH, Park H. Effect of postnatal catch-up growth on blood pressure in children at 3 years of age. J Hum Hypertens 2007; 21:868-74. [PMID: 17476289 DOI: 10.1038/sj.jhh.1002215] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Size at birth and early postnatal growth rates appear to be important determinants of cardiovascular diseases. We examined whether intrauterine growth restriction or the subsequent catch-up postnatal weight gain leads to higher blood pressure in early life to confirm that size at birth and early postnatal growth rates appear to be important determinants of blood pressure changes in early life. Of 407 children born between December 2001 and November 2002 in hospital based-birth cohorts, 102 were followed up at 3 years of age (24.2%) at Ewha Womans University Hospital in Seoul, Korea. At 3 years of age, those who had a low birth weight still belonged in the lower-weight group than the others. The subjects' systolic blood pressure was correlated with their current weight (r=0.41) and weight gain (r=0.39), but not with their birth weight. Those with a higher current weight and higher weight gain based on birth weight (conditional weight gain) had the highest blood pressure. Systolic blood pressure increased by 0.2 mm Hg for every 100-g increase in weight at 3 years and, independently, by 1.5 mm Hg for every 100-unit increase in conditional weight gain. This study suggests that birth weight is not directly associated with blood pressure, but accelerated growth, which occurs mostly in those born with a low birth weight, seems to affect blood pressure in early life.
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Affiliation(s)
- J W Min
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, South Korea
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18
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Kivimäki M, Smith GD, Elovainio M, Pulkki L, Keltikangas-Järvinen L, Talttonen L, Raitakari OT, Viikari JSA. Socioeconomic circumstances in childhood and blood pressure in adulthood: the cardiovascular risk in young Finns study. Ann Epidemiol 2006; 16:737-42. [PMID: 16843680 DOI: 10.1016/j.annepidem.2006.01.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2004] [Accepted: 07/22/2005] [Indexed: 10/24/2022]
Abstract
PURPOSE Prospective evidence suggests an inverse association between socioeconomic circumstances in childhood and adolescence and blood pressure (BP) in adulthood, but uncertainty remains about whether this association is confounded by risk factors acting in utero, early infancy, and adulthood. The authors investigated this question in a population-based cohort of 2270 Finnish children and adolescents aged 3 to 18 years at study entry. METHODS Information about early socioeconomic circumstances, birth weight, and breast-feeding were requested from participants or their mothers in 1980 and 1983. Adulthood socioeconomic position, lifestyle factors, and systolic BP were measured at ages 24 to 39 years in 2001. RESULTS There was a graded association between lower parental socioeconomic position in childhood and adolescence and higher systolic BP in adulthood for men and women in different birth cohorts and across different socioeconomic indicators. This association was independent of adulthood socioeconomic position. Adjustment for risk factors, including birth weight, breast-feeding, adult body mass index, smoking, and alcohol consumption, had little effect on the association between parental socioeconomic position and systolic BP. CONCLUSION Early socioeconomic disadvantage seems to carry a long-lasting harmful effect on BP that is not counteracted by risk profiles in later life.
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Affiliation(s)
- Mika Kivimäki
- Finnish Institute of Occupational Health, Heisinki, Finland.
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19
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Kivimäki M, Lawlor DA, Smith GD, Keltikangas-Järvinen L, Elovainio M, Vahtera J, Pulkki-Råback L, Taittonen L, Viikari JSA, Raitakari OT. Early Socioeconomic Position and Blood Pressure in Childhood and Adulthood. Hypertension 2006; 47:39-44. [PMID: 16330678 DOI: 10.1161/01.hyp.0000196682.43723.8a] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Studies have found an association between low socioeconomic position in childhood and high adult blood pressure. It is unclear whether this association is explained by a pathway directly linking disadvantage to elevated blood pressure in childhood and adolescence, which then tracks into adulthood. We assessed parental socioeconomic position and systolic blood pressure in 1807 children and adolescents ages 3 to 18 years at baseline. Adult systolic blood pressure was measured 21 years later at ages 24 to 39 years. There was strong tracking of blood pressure from childhood to adulthood. Lower parental socioeconomic position was associated with higher blood pressure in childhood, adolescence (
P
<0.01), and adulthood (
P
<0.0001), with the mean age- and sex-adjusted systolic pressure differences between the highest and lowest socioeconomic groups varying between 2.9 and 4.3 mm Hg. With adjustment for blood pressure in childhood and adolescence, the regression coefficient between parental socioeconomic position and adult blood pressure attenuated by 32%. A similar level of attenuation (28%) occurred with adjustment for adult body mass index (BMI). With adjustment for both preadult blood pressure and adult BMI, the association between parental socioeconomic position and adult blood pressure was attenuated by 45%. Other factors, including birth weight and BMI in childhood and adolescence, had little impact on the association between parental socioeconomic position and adult blood pressure. These data suggest that early socioeconomic disadvantage influences later blood pressure in part through an effect on blood pressure in early life, which tracks into adulthood, and in part through an effect on BMI.
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Affiliation(s)
- Mika Kivimäki
- Department of Psychology, University of Helsinki, Finland.
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20
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Kivimäki M, Smith GD, Juonala M, Ferrie JE, Keltikangas-Järvinen L, Elovainio M, Pulkki-Råback L, Vahtera J, Leino M, Viikari JSA, Raitakari OT. Socioeconomic position in childhood and adult cardiovascular risk factors, vascular structure, and function: cardiovascular risk in young Finns study. Heart 2005; 92:474-80. [PMID: 16159979 PMCID: PMC1860895 DOI: 10.1136/hrt.2005.067108] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To examine the association of childhood socioeconomic position (SEP) with adult cardiovascular risk factors, vascular structure, and vascular function in a contemporary population of young adults. DESIGN Population based prospective cohort study with baseline assessment in 1980. SETTING Finland. PARTICIPANTS 856 men and 1066 women whose childhood SEP was determined by parental occupational status (manual, lower non-manual, upper non-manual) at age 3-18 years. MAIN OUTCOME MEASURES Cardiovascular risk factors, carotid artery intima-media thickness, and brachial artery flow mediated vasodilatation, assessed at age 24-39 years. RESULTS After adjustment for age and adult SEP, systolic pressure was 2.3 mm Hg higher (p = 0.0002), high density lipoprotein (HDL) cholesterol 0.03 mmol/l lower (p = 0.02), and insulin resistance score (homeostasis model assessment index) 0.12 units greater (p = 0.05) among men; and systolic pressure was 1.3 mm Hg higher (p = 0.02), diastolic pressure 1.1 mm Hg higher (p = 0.01), and height 1.1 cm lower (p < 0.0001) among women for each step down the childhood SEP hierarchy. Lower childhood SEP was associated with a 20% increase in the odds of having a waist circumference > 102 cm in men and > 88 cm in women (overall p = 0.05). Childhood SEP was not associated with intima-media thickness, flow mediated vasodilatation, the metabolic syndrome, low density lipoprotein cholesterol, triglycerides, body mass index, alcohol consumption, or smoking. CONCLUSIONS Among adults under 40, low childhood SEP predicted higher blood pressure and central obesity and, among men, unfavourable HDL cholesterol and insulin resistance, independent of current SEP. No independent effects were found on adult vascular structure, vascular function, or health related behaviours at this life stage.
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Affiliation(s)
- M Kivimäki
- Department of Psychology, University of Helsinki, Helsinki, Finland.
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