Socioeconomic factors as predictors of incident heart failure.
BACKGROUND
Studies of socioeconomic factors as predictors of heart failure (HF) are few and have given opposing results. Further, it is unknown if these factors predict incident HF independently of myocardial infarction and other established risk factors for HF.


RESULTS
In a community-based cohort of 2314 middle-age men free from HF, valvular disease, and previous myocardial infarction at baseline, socioeconomic factors were examined as predictors for HF using Cox proportional hazards analyses. In multivariable Cox proportional hazards models adjusted for established risk factors for HF (hypertension, diabetes, electrocardiographic left ventricular hypertrophy, smoking, serum cholesterol, and interim myocardial infarction), low occupational classification (hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.03-2.35 for low vs. high occupational classification), low education level (HR 1.98, 95% CI 1.07-3.68 for elementary school vs. college exam) and being unmarried (HR 1.44, 95% CI 0.99-2.10 for being unmarried vs. being married) increased the risk of HF.


CONCLUSIONS
High occupational classification and high education level decreased, and being unmarried increased, the risk of subsequent HF in middle-age men, via mechanisms largely independent of established risk factors for HF, including an interim myocardial infarction. Further studies are needed to understand the mechanisms behind these associations.
Ingelsson
Erik
E
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Lind
Lars
L
Arnlöv
Johan
J
Sundström
Johan
J
D015331:Cohort Studies; D004522:Educational Status; D004651:Employment; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D012959:Socioeconomic Factors