Socioeconomic status, ABO phenotypes and risk of ischaemic heart disease: an 8-year follow-up in the Copenhagen Male Study.
OBJECTIVE
The association of socioeconomic status with the risk of ischaemic heart disease is only partly explained by the uneven distribution of conventional risk factors. We tested the hypothesis that an uneven socioeconomic distribution of ABO phenotypes could contribute to the explanation.


METHODS
A prospective study controlling for age and other relevant potential confounders: smoking, physical activity, wine consumption, height, weight, serum lipids, blood pressure, hypertension, type II diabetes, serum selenium concentration and soldering fumes exposure.


METHODS
The Copenhagen Male Study, Denmark.


METHODS
Two thousand, nine hundred and ninety-three men aged 53-74 years without overt ischaemic heart disease.


METHODS
Incidence of ischaemic heart disease in an 8-year follow-up.


RESULTS
Two hundred and forty-two men (8.1%) had a first ischaemic heart disease event. There was no association between socioeconomic status and the ABO blood group phenotypes and, in accordance with this, ABO phenotype was not a confounder for the association of socioeconomic status with the risk of ischaemic heart disease. However, ABO blood group was a strong risk or effect modifier. Only among men with the O phenotype was socioeconomic status (social classes IV and V versus social classes I, II and III) associated with a significant excess risk (relative risk 1.7, 95% confidence interval 1.1-2.7 and P = 0.02 after adjustment for confounders; the corresponding relative risks among the A and B/AB phenotypes comparing low social classes with the higher social classes were 1.08 (P = 0.77) and 1.08 (P = 0.89), respectively).


CONCLUSIONS
ABO phenotypes did not contribute directly to the explanation of socioeconomic inequalities in the risk of ischaemic heart disease. However, the finding of ABO phenotypes being effect modifiers for the association of socioeconomic status with the risk of ischaemic heart disease may open up new possibilities of clarifying the roles of socioeconomic status and ABO blood group as cardiovascular disease risk factors.
Suadicani
P
P
Epidemiological Research Unit, Copenhagen University Hospital, Denmark. poul.suadicani@jubiipost.dk
Hein
H O
HO
Gyntelberg
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F
D000017:ABO Blood-Group System; D000368:Aged; D016009:Chi-Square Distribution; D015986:Confounding Factors, Epidemiologic; D003718:Denmark / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D009790:Occupations; D010641:Phenotype; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D012923:Social Class
D000017:ABO Blood-Group System