This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Berkman, L. F. Search for Related Content PubMed PubMed Citation Articles by Berkman, L. F. Related Collections Glucose intolerance Acute myocardial infarction Epidemiology Related Article

(Circulation. 2005;111:3022-3024.)
© 2005 American Heart Association, Inc.

Editorial

Tracking Social and Biological Experiences

The Social Etiology of Cardiovascular Disease

Lisa F. Berkman, PhD

From the Harvard School of Public Health, Boston, Mass.

Correspondence to Dr Lisa F. Berkman, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115. E-mail lberkman@hsph.harvard.edu

Key Words: Editorials • cardiovascular disease • mortality • socioeconomic factors

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

	Introduction

 
The social gradient in cardiovascular disease (CVD) is well known. There are literally scores of studies showing that men and women who are socially disadvantaged are at increased risk of developing CVD and have a worse prognosis once they develop the disease.¹ During the last 40 years, in most industrialized countries, a clear pattern has emerged showing that each increase in socioeconomic position confers a decreased risk in cardiovascular morbidity and mortality. Men between the ages of 25 and 64 who are the most disadvantaged have an 2.5-fold risk of dying of CVD. For women, the risks are even greater (3.4-fold risk).² Similar trends are seen for risk-related disorders, including hypertension and diabetes. The causes and mediating pathways by which this occurs are not nearly as well characterized, however. Identifying the biological and behavioral mechanisms that link economic and social disadvantage to cardiovascular morbidity and mortality provides valuable insights into the causes of CVD and information about where along the spectrum of disease development we may effectively intervene to improve outcomes in disadvantaged populations. There is little debate about the social patterning and distribution of CVD. There is, however, ongoing debate about the reason for the observed patterns.

See p 3071

Much of the social gradient was attributed originally to the uneven distribution of a number of health behaviors related to diet, tobacco consumption, physical inactivity, compliance with therapeutic regimens, and differential access to high-quality medical care. As the story goes, as better educated, economically advantaged men and women learned . . . [Full Text of this Article]

Related Article:

Does Autonomic Function Link Social Position to Coronary Risk?: The Whitehall II Study

Harry Hemingway, Martin Shipley, Eric Brunner, Annie Britton, Marek Malik, and Michael Marmot
Circulation 2005 111: 3071-3077. [Abstract] [Full Text]

This article has been cited by other articles:

				L. R. Zacharski, B. K. Chow, P. S. Howes, G. Shamayeva, J. A. Baron, R. L. Dalman, D. J. Malenka, C. K. Ozaki, and P. W. Lavori Reduction of Iron Stores and Cardiovascular Outcomes in Patients With Peripheral Arterial Disease: A Randomized Controlled Trial JAMA, February 14, 2007; 297(6): 603 - 610. [Abstract] [Full Text] [PDF]

				D. Lucini, S. Riva, P. Pizzinelli, and M. Pagani Stress Management at the Worksite: Reversal of Symptoms Profile and Cardiovascular Dysregulation Hypertension, February 1, 2007; 49(2): 291 - 297. [Abstract] [Full Text] [PDF]

				M. H. Shishehbor, D. Litaker, C. E. Pothier, and M. S. Lauer Association of Socioeconomic Status With Functional Capacity, Heart Rate Recovery, and All-Cause Mortality JAMA, February 15, 2006; 295(7): 784 - 792. [Abstract] [Full Text] [PDF]