Academic Journal
The association between education and cardiovascular disease incidence is mediated by hypertension, diabetes, and body mass index
العنوان: | The association between education and cardiovascular disease incidence is mediated by hypertension, diabetes, and body mass index |
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المؤلفون: | Dégano, Irene R, Marrugat de la Iglesia, Jaume, Grau, Maria, Salvador-González, Betlem, Ramos, Rafel, Zamora, Alberto, Elosua, Roberto, Martí Lluch, Ruth |
المساهمون: | Dégano IR, Marrugat J, Elosua R CIBER de Enfermedades Cardiovasculares (CIBERCV), ISCIII, Madrid, Spain. Registre Gironí del Cor REGICOR, Epidemiologia i Genètica Cardiovascular, Programa d’Epidemiologia i Salut Pública, Institut Hospital del Mar d’Investigacions mediques, (IMIM), Barcelona, Spain. Grau M Registre Gironí del Cor REGICOR, Epidemiologia i Genètica Cardiovascular, Programa d’Epidemiologia i Salut Pública, Institut Hospital del Mar d’Investigacions mediques, (IMIM), Barcelona, Spain. Facultat de Farmàcia i Ciències dels Aliments, Universitat de Barcelona (UB), Barcelona, Spain. Salvador-González B Registre Gironí del Cor REGICOR, Epidemiologia i Genètica Cardiovascular, Programa d’Epidemiologia i Salut Pública, Institut Hospital del Mar d’Investigacions mediques, (IMIM), Barcelona, Spain. Equip d'atenció primària (ABS l'Hospitalet de Ll. 8-Florida sud), Centre d’Atenció Primària (CAP) Florida, L’Hospitalet de Llobregat, Spain. Grupo de Estudio de Enfermedad Cardiovascular en Atención Primaria (MACAP) de Costa Ponent, Institut d’Investigació en Atenció Primària IDIAP Jordi Gol, Institut Català de la Salut, L’Hospitalet de Llobregat, Barcelona, Spain. Ramos R Grup d’Investigació en Salut Vascular de Girona (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain. Grup de recerca Translab, Departament de Ciències Mèdiques, Universitat de Girona, Girona, Spain. Àmbit d’atenció Primaria, Institut Català de la Salut, Departament de Salut, Generalitat de Catalunya, Girona, Spain. Zamora A Grup de recerca Translab, Departament de Ciències Mèdiques, Facultat de Medicina, Universitat de Girona, Girona, Spain. Unitat de Lípids i arteriosclerosi, Departament de Medicina Interna, Hospital de Blanes, Girona, Spain. Martí R Grup d’Investigació en Salut Vascular (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain. Institut d’Investigació Biomèdica de Girona (IDIBGI), Hospital Universitari Dr. Josep Trueta, Girona, Spain, IDIAP Jordi Gol |
المصدر: | Scientia |
بيانات النشر: | Nature Publishing Group |
سنة النشر: | 2017 |
مصطلحات موضوعية: | Diabetis, Hipertensió, Sistema cardiovascular - Malalties, Educació, Pes corporal - Regulació, DISEASES::Nutritional and Metabolic Diseases::Metabolic Diseases::Glucose Metabolism Disorders::Diabetes Mellitus, DISEASES::Cardiovascular Diseases::Vascular Diseases::Hypertension, HEALTH CARE::Environment and Public Health::Public Health::Epidemiologic Measurements::Biometry::Anthropometry::Body Mass Index, DISEASES::Cardiovascular Diseases, SCIENCE AND HEALTH::Health Sciences, Technology and Innovation Management::Science, Technology and Society::Population Education, ENFERMEDADES::enfermedades nutricionales y metabólicas::enfermedades metabólicas::trastornos del metabolismo de la glucosa::diabetes mellitus, ENFERMEDADES::enfermedades cardiovasculares::enfermedades vasculares::hipertensión, ATENCIÓN DE SALUD::ambiente y salud pública::salud pública::medidas epidemiológicas::biometría::antropometría::índice de masa corporal, ENFERMEDADES::enfermedades cardiovasculares, CIENCIA Y SALUD::gestión de ciencia, tecnología e innovación en salud::ciencia, tecnología y sociedad::educación de la población |
الوصف: | Malalties cardiovasculars; Nivell Educacional; Diabetis ; Enfermedades cardiovasculares; Nivel Educacional; Diabetes ; Cardiovascular Diseases; Educational Level; Diabetes ; Education and cardiovascular disease (CVD) are inversely associated but the mediating factors have not been totally elucidated. Our aim was to analyze the mediating role of modifiable risk factors. Cohort study using the REGICOR population cohorts. Participants without previous CVD were included (n = 9226). Marginal structural models were used to analyze the association between education and CVD incidence at 6 years of follow-up. Mediation by modifiable risk factors (diabetes, dyslipidemia, hypertension, smoking, body mass index, and physical activity) was assessed using the counterfactual framework. Participants with a university degree had a CVD incidence hazard ratio (HR) of 0.51 (95% confidence interval (CI) = 0.30, 0.85), compared to those with primary or lower education. Only hypertension, BMI, and diabetes mediated the association between education and CVD incidence, accounting for 26% of the association (13.9, 6.9, and 5.2%, respectively). Sensitivity analyses showed that hypertension was the strongest mediator (average causal mediation effect [95% CI] = increase of 2170 days free of CVD events [711, 4520]). The association between education and CVD incidence is partially mediated by hypertension, BMI, and diabetes. Interventions to decrease the prevalence of these risk factors could contribute to diminish the CVD inequalities associated with educational level. |
نوع الوثيقة: | article in journal/newspaper |
وصف الملف: | application/pdf |
اللغة: | English |
تدمد: | 2045-2322 |
Relation: | Scientific Reports;7(1); https://www.nature.com/articles/s41598-017-10775-3; Dégano IR, Marrugat J, Grau M, Salvador-González B, Ramos R, Zamora A, et al. The association between education and cardiovascular disease incidence is mediated by hypertension, diabetes, and body mass index. Sci Rep. 2017 Sep 28;7(1):12370.doi:10.1038/s41598-017-10775-3; https://hdl.handle.net/11351/3534 |
DOI: | 10.1038/s41598-017-10775-3 |
الاتاحة: | https://hdl.handle.net/11351/3534 https://doi.org/10.1038/s41598-017-10775-3 |
Rights: | Atribución-NoComercial-SinDerivadas 3.0 España ; http://creativecommons.org/licenses/by-nc-nd/3.0/es/ ; info:eu-repo/semantics/openAccess |
رقم الانضمام: | edsbas.573241B3 |
قاعدة البيانات: | BASE |
تدمد: | 20452322 |
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DOI: | 10.1038/s41598-017-10775-3 |