Journal Article

Life Course Socioeconomic Position: Associations with Cardiac Structure and Function at Age 60-64 Years in the 1946 British Birth Cohort

Deanfield, John, Whincup, Peter, Thomas, Claudia, Ghosh, Arjun K., Murray, Emily T., Sattar, Naveed, Hardy, Rebecca, Kuh, Diana, Hughes, Alun D., Jones, Rebecca

2016

Overview

Although it is recognized that risks of cardiovascular diseases associated with heart failure develop over the life course, no studies have reported whether life course socioeconomic inequalities exist for heart failure risk. The Medical Research Council's National Survey of Health and Development was used to investigate associations between occupational socioeconomic position during childhood, early adulthood and middle age and measures of cardiac structure [left ventricular (LV) mass index and relative wall thickness (RWT)] and function [systolic: ejection fraction (EF) and midwall fractional shortening (mFS); diastolic: left atrial (LA) volume, E/A ratio and E/e' ratio)]. Different life course models were compared with a saturated model to ascertain the nature of the relationship between socioeconomic position across the life course and each cardiac marker. Findings showed that models where socioeconomic position accumulated over multiple time points in life provided the best fit for 3 of the 7 cardiac markers: childhood and early adulthood periods for the E/A ratio and E/e' ratio, and all three life periods for LV mass index. These associations were attenuated by adjustment for adiposity, but were little affected by adjustment for other established or novel cardio-metabolic risk factors. There was no evidence of a relationship between socioeconomic position at any time point and RWT, EF, mFS or LA volume index. In conclusion, socioeconomic position across multiple points of the lifecourse, particularly earlier in life, is an important determinant of some measures of LV structure and function. BMI may be an important mediator of these associations.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adipose tissue / Age composition / Alcohol use / Biology and Life Sciences / Body mass / Body Mass Index / Cardiovascular disease / Cardiovascular diseases / Cardiovascular Diseases - diagnosis / Cardiovascular Diseases - epidemiology / Children / Cohort analysis / Cohort Studies / Comparative analysis / Coronary artery disease / Echocardiography / Economic aspects / Female / Health aspects / Health risks / Heart diseases / Heart failure / Humans / Male / Medical research / Medicine and Health Sciences / Middle Aged / Mortality / Myocardium - pathology / Occupations / People and Places / Position measurement / Research and Analysis Methods / Risk analysis / Risk Factors / Social aspects / Social class / Social Sciences / Socio-economic aspects / Socioeconomic Factors / Socioeconomics / Structure-function relationships / Studies / Surveys / United Kingdom - epidemiology / Ventricle / Wall thickness