Abstract P329: Educational Attainment and Lifetime Risk of Cardiovascular Disease: the Atherosclerosis Risk in Communities Study
Background: Estimates of lifetime risk may help raise awareness of the extent to which educational inequalities affect risk of cardiovascular disease (CVD). To date, no study has reported the lifetime risk of CVD according to categories of educational attainment.
Objectives: To estimate the lifetime risk of CVD from 45 through 85 years according to educational attainment.
Methods: We followed 13,948 whites and African Americans initially free of CVD from 1,987 through 2,013, and used a life table approach to estimate lifetime risks of life-threatening CVD events (coronary heart disease, heart failure and stroke) according to educational attainment (grade school, high school without graduation, high school graduation, vocational school, college with or without graduation, and graduate/professional school). We adjusted for competing risks of death from underlying causes other than CVD.
Results: During the 269,210 person-years of follow-up, we documented 4,512 CVD events, and 2,401 non-CVD deaths. Educational attainment displayed an inverse dose-response relation with cumulative risk of CVD, which became evident in middle-age, with the most striking gap between those not completing versus completing high school. Lifetime risk estimates of CVD from age 45 years though 85 years were 55.0% (95% confidence interval, 51.4-58.6) for grade school, 50.5% (47.3-53.3) for high school education without graduation, 41.7% (39.5-43.8) for high school graduation, 39.7% (35.5-43.4) for vocational school, 39.2% (36.4-41.4) for college with or without graduation, and 36.1% (31.9-39.7) for graduate/professional school. For both men and women, and whites as well as African Americans, those who did not graduate from high school had a sizably higher lifetime CVD risk. There was a similar pattern for cumulative CVD risk to 65 years. Lower family income and parental educational attainment were also associated with greater lifetime CVD risk, but individuals with more than a high school education had a lower lifetime risk than those with less educational attainment, regardless of their income or parental educational attainment.
Conclusions: Educational attainment was inversely associated with the lifetime risk of CVD, and cumulative risk differences were already evident during middle-age, suggesting that greater educational attainment might promote lower lifetime risk of CVD.
Author Disclosures: Y. Kubota: None. G. Heiss: None. R.F. MacLehose: None. N.S. Roetker: None. A.R. Folsom: None.
- © 2017 by American Heart Association, Inc.