Abstract P091: The Association of Socioeconomic Status and Subclinical Atherosclerosis in a Rural Bangladesh Population
Background: Cardiovascular mortality has risen 30 fold in South Asia yet there is little data on how socioeconomic status (SES) contributes to the rising cardiovascular disease (CVD) burden. In Bangladesh, CVD accounts for the majority of non-communicable mortality. The purpose of this study was to determine the role of SES on subclinical atherosclerosis measured as carotid intima media thickness (cIMT) in a rural Bangladesh population.
Methods: cIMT was measured in 1022 participants (average age 46, 40% male) randomly selected from the Health Effects of Arsenic Longitudinal Study (HEALS), a population-based prospective cohort study based in rural Bangladesh. SES was measured with survey data as occupation type, land ownership, educational attainment, and television ownership. We assessed the association between each of these SES indicators and cIMT adjusting for potential confounders.
Results: Over half of the participants received formal education (53%) and under half owned land (48%) and a television (44%). Women were primarily homemakers (95%) and men worked as factory workers (24%), laborers (18%), or in business (55%). In univariate analysis, those owning greater than one acre of land (p = 0.03), owning a television (p =0.02), or laborers and business owners when compared to factory workers had higher levels of cIMT (p<0.01). Educational attainment was not an independent predictor of cIMT (p = 0.7). In multivariate analysis after adjustment for potential confounders, men employed in the business sector had a 26.7 μm (95% CI 6.7 - 46.9, p < 0.01) significantly greater level of cIMT when compared to factory workers. The association was strongest in older men (50.8 μm, 95% CI 9.0 - 92.6, ≥50 years old compared to younger men (19.4 μm, 95% CI -2.0 - 40.9, <50 years old). Other SES indicators were not predictors of cIMT after multivariate adjustment.
Conclusion: Working in the business sector was positively associated with subclinical atherosclerosis after adjustment for confounders. This finding is consistent with evidence from other developing nations suggesting that certain SES factors are independent predictors of CVD.
Author Disclosures: M. Garshick: None. F. Wu: None. A. Ahmed: None. G. Sarwar: None. Y. Chen: None.
- © 2017 by American Heart Association, Inc.