title: Association between education and the risk of incident coronary heart disease among middle-aged and older Chinese: the Dongfeng-Tongji Cohort.
abstract: Educational achievement was related to cardiovascular disease in some western populations, but prospective evidence on the relationship between education and the risk of incident coronary heart disease (CHD) in Asians is scarce. We aimed to explore this association and the potential modifying effect of major CHD risk factors related to education in middle-aged and older Chinese adults. We included 18,551 participants with mean age 62.8 years at baseline between September 2008 and June 2010, and followed the population until October 2013. Cox proportional hazard models and log-binomial regression models were used for multivariate analyses. Compared with participants with low education, the adjusted hazard ratio (HR) and 95% confidence interval (95% CI) for incident CHD in those with high education was 0.89 (95% CI: 0.80, 0.98). In addition, such inverse association between education and the risk of incident CHD was more evident among individuals who were more than 60 years, physically active, overweight, and hypertension. Besides, decreases in the relative index of inequality with high education versus low education were from 0.83 to 0.76 for hypertension, from 0.85 to 0.82 for diabetes. In conclusion, education was inversely associated with the risk of incident CHD among middle-aged and older Chinese adults.
authors.affiliation: Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Yuan
authors.affiliation: Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Lulu
authors.initials: L
authors.lastname: Song
authors.affiliation: Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Gaokun
authors.initials: G
authors.lastname: Qiu
authors.affiliation: Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Lai
authors.affiliation: Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Liangle
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Xiao
authors.affiliation: Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Lue
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, China.
authors.forename: Handong
authors.initials: H
authors.lastname: Yang
authors.affiliation: Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, China.
authors.forename: Xiulou
authors.initials: X
authors.lastname: Li
authors.affiliation: Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, China.
authors.forename: Chengwei
authors.initials: C
authors.lastname: Xu
authors.affiliation: Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Xiaomin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Mei-An
authors.initials: MA
authors.lastname: He
authors.affiliation: Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. wut@mails.tjmu.edu.cn.
authors.forename: Tangchun
authors.initials: T
authors.lastname: Wu
mesh_terms: D000367:Age Factors; D000368:Aged; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D016016:Proportional Hazards Models; D012306:Risk; D012959:Socioeconomic Factors