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Roles of allostatic load, lifestyle and clinical risk factors in mediating the association between education and coronary heart disease risk in Europe

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Roles of allostatic load, lifestyle and clinical risk factors in mediating the association between education and coronary heart disease risk in Europe. / Hicks, Blánaid; Veronesi, Giovanni; Ferrario, Marco M; Forrest, Hannah; Whitehead, Margaret; Diderichsen, Finn; Tunstall-Pedoe, Hugh; Kuulasmaa, Kari; Sans, Susana; Salomaa, Veikko; Thorand, Barbara; Peters, Annette; Soderberg, Stefan; Cesana, Giancarlo; Bobak, Martin; Iacoviello, Licia; Palmieri, Luigi; Zeller, Tanja; Blankenberg, Stefan; Kee, Frank; MORGAM/BiomarCaRE consortium.

In: J EPIDEMIOL COMMUN H, Vol. 75, No. 12, 12.2021, p. 1147-1154.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Hicks, B, Veronesi, G, Ferrario, MM, Forrest, H, Whitehead, M, Diderichsen, F, Tunstall-Pedoe, H, Kuulasmaa, K, Sans, S, Salomaa, V, Thorand, B, Peters, A, Soderberg, S, Cesana, G, Bobak, M, Iacoviello, L, Palmieri, L, Zeller, T, Blankenberg, S, Kee, F & MORGAM/BiomarCaRE consortium 2021, 'Roles of allostatic load, lifestyle and clinical risk factors in mediating the association between education and coronary heart disease risk in Europe', J EPIDEMIOL COMMUN H, vol. 75, no. 12, pp. 1147-1154. https://doi.org/10.1136/jech-2020-215394

APA

Hicks, B., Veronesi, G., Ferrario, M. M., Forrest, H., Whitehead, M., Diderichsen, F., Tunstall-Pedoe, H., Kuulasmaa, K., Sans, S., Salomaa, V., Thorand, B., Peters, A., Soderberg, S., Cesana, G., Bobak, M., Iacoviello, L., Palmieri, L., Zeller, T., Blankenberg, S., ... MORGAM/BiomarCaRE consortium (2021). Roles of allostatic load, lifestyle and clinical risk factors in mediating the association between education and coronary heart disease risk in Europe. J EPIDEMIOL COMMUN H, 75(12), 1147-1154. https://doi.org/10.1136/jech-2020-215394

Vancouver

Hicks B, Veronesi G, Ferrario MM, Forrest H, Whitehead M, Diderichsen F et al. Roles of allostatic load, lifestyle and clinical risk factors in mediating the association between education and coronary heart disease risk in Europe. J EPIDEMIOL COMMUN H. 2021 Dec;75(12):1147-1154. https://doi.org/10.1136/jech-2020-215394

Bibtex

@article{c9ac48ae348f42c29abbf11c8ffd7bad,
title = "Roles of allostatic load, lifestyle and clinical risk factors in mediating the association between education and coronary heart disease risk in Europe",
abstract = "BACKGROUND: Previous studies have shown that differential exposure to lifestyle factors may mediate the association between education and coronary heart diseases (CHD). However, few studies have examined the potential roles of allostatic load (AL) or differential susceptibility.METHODS: 25 310 men and 26 018 women aged 35-74 and CHD free at baseline were identified from 21 European cohorts and followed for a median of 10 years, to investigate the mediating role of AL, as well as of smoking, alcohol use and body mass index (BMI), on educational differences in CHD incidence, applying marginal structural models and three-way decomposition.RESULTS: AL is a mediator of the association between educational status and CHD incidence, with the highest proportion mediated observed among women and largely attributable to differential exposure, (28% (95% CI 19% to 44%)), with 8% (95% CI 0% to 16%) attributable to differential susceptibility. The mediating effects of smoking, alcohol and BMI, compared with AL, were relatively small for both men and women.CONCLUSION: Overall, the educational inequalities in CHD incidence were partially mediated through differential exposure to AL. By contrast, the mediation of the educational gradient in CHD by investigated lifestyle risk factors was limited. As differential susceptibility in men was found to have a predominant role in the accumulation of AL in low educational classes, the investigation of AL-related risk factors is warranted.",
keywords = "Allostasis, Coronary Disease/epidemiology, Educational Status, Europe/epidemiology, Female, Humans, Life Style, Male, Risk Factors, Smoking",
author = "Bl{\'a}naid Hicks and Giovanni Veronesi and Ferrario, {Marco M} and Hannah Forrest and Margaret Whitehead and Finn Diderichsen and Hugh Tunstall-Pedoe and Kari Kuulasmaa and Susana Sans and Veikko Salomaa and Barbara Thorand and Annette Peters and Stefan Soderberg and Giancarlo Cesana and Martin Bobak and Licia Iacoviello and Luigi Palmieri and Tanja Zeller and Stefan Blankenberg and Frank Kee and {MORGAM/BiomarCaRE consortium}",
note = "{\textcopyright} Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2021",
month = dec,
doi = "10.1136/jech-2020-215394",
language = "English",
volume = "75",
pages = "1147--1154",
journal = "J EPIDEMIOL COMMUN H",
issn = "0143-005X",
publisher = "BMJ PUBLISHING GROUP",
number = "12",

}

RIS

TY - JOUR

T1 - Roles of allostatic load, lifestyle and clinical risk factors in mediating the association between education and coronary heart disease risk in Europe

AU - Hicks, Blánaid

AU - Veronesi, Giovanni

AU - Ferrario, Marco M

AU - Forrest, Hannah

AU - Whitehead, Margaret

AU - Diderichsen, Finn

AU - Tunstall-Pedoe, Hugh

AU - Kuulasmaa, Kari

AU - Sans, Susana

AU - Salomaa, Veikko

AU - Thorand, Barbara

AU - Peters, Annette

AU - Soderberg, Stefan

AU - Cesana, Giancarlo

AU - Bobak, Martin

AU - Iacoviello, Licia

AU - Palmieri, Luigi

AU - Zeller, Tanja

AU - Blankenberg, Stefan

AU - Kee, Frank

AU - MORGAM/BiomarCaRE consortium

N1 - © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2021/12

Y1 - 2021/12

N2 - BACKGROUND: Previous studies have shown that differential exposure to lifestyle factors may mediate the association between education and coronary heart diseases (CHD). However, few studies have examined the potential roles of allostatic load (AL) or differential susceptibility.METHODS: 25 310 men and 26 018 women aged 35-74 and CHD free at baseline were identified from 21 European cohorts and followed for a median of 10 years, to investigate the mediating role of AL, as well as of smoking, alcohol use and body mass index (BMI), on educational differences in CHD incidence, applying marginal structural models and three-way decomposition.RESULTS: AL is a mediator of the association between educational status and CHD incidence, with the highest proportion mediated observed among women and largely attributable to differential exposure, (28% (95% CI 19% to 44%)), with 8% (95% CI 0% to 16%) attributable to differential susceptibility. The mediating effects of smoking, alcohol and BMI, compared with AL, were relatively small for both men and women.CONCLUSION: Overall, the educational inequalities in CHD incidence were partially mediated through differential exposure to AL. By contrast, the mediation of the educational gradient in CHD by investigated lifestyle risk factors was limited. As differential susceptibility in men was found to have a predominant role in the accumulation of AL in low educational classes, the investigation of AL-related risk factors is warranted.

AB - BACKGROUND: Previous studies have shown that differential exposure to lifestyle factors may mediate the association between education and coronary heart diseases (CHD). However, few studies have examined the potential roles of allostatic load (AL) or differential susceptibility.METHODS: 25 310 men and 26 018 women aged 35-74 and CHD free at baseline were identified from 21 European cohorts and followed for a median of 10 years, to investigate the mediating role of AL, as well as of smoking, alcohol use and body mass index (BMI), on educational differences in CHD incidence, applying marginal structural models and three-way decomposition.RESULTS: AL is a mediator of the association between educational status and CHD incidence, with the highest proportion mediated observed among women and largely attributable to differential exposure, (28% (95% CI 19% to 44%)), with 8% (95% CI 0% to 16%) attributable to differential susceptibility. The mediating effects of smoking, alcohol and BMI, compared with AL, were relatively small for both men and women.CONCLUSION: Overall, the educational inequalities in CHD incidence were partially mediated through differential exposure to AL. By contrast, the mediation of the educational gradient in CHD by investigated lifestyle risk factors was limited. As differential susceptibility in men was found to have a predominant role in the accumulation of AL in low educational classes, the investigation of AL-related risk factors is warranted.

KW - Allostasis

KW - Coronary Disease/epidemiology

KW - Educational Status

KW - Europe/epidemiology

KW - Female

KW - Humans

KW - Life Style

KW - Male

KW - Risk Factors

KW - Smoking

U2 - 10.1136/jech-2020-215394

DO - 10.1136/jech-2020-215394

M3 - SCORING: Journal article

C2 - 34049926

VL - 75

SP - 1147

EP - 1154

JO - J EPIDEMIOL COMMUN H

JF - J EPIDEMIOL COMMUN H

SN - 0143-005X

IS - 12

ER -