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(Circulation. 2005;111:3020-3021.)
© 2005 American Heart Association, Inc.

Editorial

Persistent Social Patterning of Cardiovascular Risk

Rethinking the Familiar

Ana V. Diez Roux, MD, PhD

From the Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor.

Reprints requests to Ana V. Diez Roux, MD, PhD, Department of Epidemiology, University of Michigan, 1214 South University, 2nd Floor, Ann Arbor, MI 48103. E-mail adiezrou@umich.edu

Key Words: Editorials • cardiovascular diseases • myocardial infarction • socioeconomic factors • mortality

An extract of the first 250 words of the full text is provided, because this article has no abstract.

There is abundant evidence that cardiovascular disease is strongly patterned by socioeconomic position.¹ Contrary to the stereotypical image of the wealthy but stressed executive who dies of a heart attack, people in the lowest socioeconomic strata, whether defined by income, education, or occupation, are consistently at greater risk of cardiovascular disease, at least in industrialized countries. Interestingly, the increased risk is not limited to the very poor but appears to decrease in quite a remarkable graded fashion, as socioeconomic resources increase.^2,3 This graded relationship, which is observed for virtually all indicators of socioeconomic position, is striking given the crudeness with which social factors are usually measured in epidemiological and clinical studies, and the fact that these factors are necessarily very distal to the biological processes that lead to the development of atherosclerosis and the precipitation of clinical events. The strength and persistence of these patterns suggest a pervasive influence of social context on the body and on the cardiovascular system in particular. However, like many things that we are used to seeing over and over again, with time they become invisible and their significance is forgotten.

See p 3063

In this issue of Circulation, Tonne et al⁴ report a graded, inverse association between neighborhood deprivation and long-term survival after an acute myocardial infarction (AMI). Although there have been numerous reports of the socioeconomic patterning of cardiovascular mortality, few have investigated whether these mortality differences result from differences in the incidence of disease or from differences in survival of individuals . . . [Full Text of this Article]

Related Article:

Long-Term Survival After Acute Myocardial Infarction Is Lower in More Deprived Neighborhoods

Cathryn Tonne, Joel Schwartz, Murray Mittleman, Steve Melly, Helen Suh, and Robert Goldberg
Circulation 2005 111: 3063-3070. [Abstract] [Full Text]

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