Life-course perspective on socioeconomic differences in carotid atherosclerosis.
OBJECTIVE
Socioeconomic status (SES) in adulthood is known to be related to carotid atherosclerosis. However, few studies have tried to assess its association with SES from a life-course perspective.


RESULTS
We examined the relationship between SES in childhood and in adulthood and carotid atherosclerosis in a general population of Swedish men and women. Carotid stenosis was determined by B-mode ultrasound. Results showed that women whose fathers' occupations involved unskilled manual labor had higher odds of carotid stenosis than did women whose fathers' occupations involved high- or medium-level nonmanual labor, even after adjustment for adult occupational status and risk factors (odds ratio 1.8, 95% CI 1.1 to 2.8). No such association appeared in men. Furthermore, the impact of life-course SES on atherosclerosis was examined by using an additive measure of one's combined SES during childhood and adulthood. Among women, the odds of carotid stenosis increased with a rise in exposure to low SES during the life-course (P for trend <0.001). In men, no such trend was found.


CONCLUSIONS
The results indicate that the total life-course exposure to low SES, with contributions from childhood and adulthood, seems to play a role in atherogenesis in women. Such a pattern of association could not be shown in men.
Rosvall
Maria
M
Department of Community Medicine, Lund University, Malmö, Sweden. maria.rosvall@smi.mas.lu.se
Ostergren
Per-Olof
PO
Hedblad
Bo
B
Isacsson
Sven-Olof
SO
Janzon
Lars
L
Berglund
Göran
G
D000367:Age Factors; D000368:Aged; D002340:Carotid Artery Diseases / Q000453:epidemiology*; D016893:Carotid Stenosis / Q000453:epidemiology; D004651:Employment / Q000145:classification / Q000191:economics; D005191:Family Characteristics; D005220:Fathers / Q000145:classification / Q000193:education; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D013548:Sweden