Prevention & lipidsCohort study
Contribution of income and job strain to the association between education and cardiovascular disease in 1.6 million Danish employees
- Prospective cohort study
- nationwide register-based
Authors' conclusion
Low education predicted incident CVD in initially healthy individuals and CVD mortality in individuals with prevalent cardiometabolic disease. In men with cardiometabolic disease, income and job strain explained half of the higher CVD mortality in the low education group. In healthy men and in women regardless of cardiometabolic disease, these factors explained 21-33% of the higher CVD morbidity and mortality.
Study context
- Population
- Employed Danish residents aged 30–59 years in 200041,944 with cardiometabolic disease
- Participants
- 1,638,270 residents
- Exposure
- Low vs high education, before and after adjustment for income and job strain
- Outcome
- Incident CVD (free of cardiometabolic disease) and CVD mortality (with cardiometabolic disease)
- Follow-up
- Until 2014
Main finding
As reported in the abstract
Incident CVD, low vs higher education, before and after adjustment for income and job strain
Risk
- Low education · men; before adjustment for income and job strain
- 1.62 (95% CI 1.58–1.66)
- Low education · men; after adjustment for income and job strain
- 1.46 (95% CI 1.42–1.50)
- Women · low education; before adjustment for income and job strain
- 1.66 (95% CI 1.61–1.72)
- Women · low education; after adjustment for income and job strain
- 1.53 (95% CI 1.47–1.58)
- Reduction in estimate after adjustment, men
- 25%
- Reduction in estimate after adjustment, women
- 21%
Observational data: associations, not effects.
Further findings
Cardiovascular disease (CVD) mortality in individuals with cardiometabolic disease
- CVD deaths, men (362 234 person-years)
- 1736
- CVD deaths, women (179 402 person-years)
- 341
- Reduction in estimate after adjustment for income and job strain, men
- 54%
- Reduction in estimate after adjustment for income and job strain, women
- 33%
- Education predicted CVD mortality in both sexes
Original publication
Contribution of income and job strain to the association between education and cardiovascular disease in 1.6 million Danish employees. Eur Heart J. Published 17 December 2019. doi:10.1093/eurheartj/ehz870
Summarised from the published abstract; every number is checked against it