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01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Public Health 1/2017

The educational gradient in cardiovascular risk factors: impact of shared family factors in 228,346 Norwegian siblings

Zeitschrift:
BMC Public Health > Ausgabe 1/2017
Autoren:
Inger Ariansen, Laust Hvas Mortensen, Sidsel Graff-Iversen, Hein Stigum, Marte Karoline Råberg Kjøllesdal, Øyvind Næss
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12889-017-4123-0) contains supplementary material, which is available to authorized users.

Abstract

Background

Various indicators of childhood socioeconomic position have been related to cardiovascular disease (CVD) risk in adulthood. We investigated the impact of shared family factors on the educational gradient in midlife CVD risk factors by assessing within sibling similarities in the gradient using a discordant sibling design.

Methods

Norwegian health survey data (1980–2003) was linked to educational and generational data. Participants with a full sibling in the health surveys (228,346 individuals in 98,046 sibships) were included. Associations between attained educational level (7–9 years, 10–11 years, 12 years, 13–16 years, or >16 years) and CVD risk factor levels in the study population was compared with the corresponding associations within siblings.

Results

Educational gradients in risk factors were attenuated when factors shared by siblings was taken into account: A one category lower educational level was associated with 0.7 (95% confidence interval 0.6 to 0.8) mm Hg higher systolic blood pressure (27% attenuation), 0.4 (0.4 to 0.5) mmHg higher diastolic blood pressure (30%), 1.0 (1.0 to 1.1) more beats per minute higher heart rate (21%), 0.07 (0.06 to 0.07) mmol/l higher serum total cholesterol (32%), 0.2 (0.2 to 0.2) higher smoking level (5 categories) (30%), 0.15 (0.13 to 0.17) kg/m2 higher BMI (43%), and 0.2 (0.2 to 0.2) cm lower height (52%). Attenuation increased with shorter age-difference between siblings.

Conclusion

About one third of the educational gradients in modifiable CVD risk factors may be explained by factors that siblings share. This implies that childhood environment is important for the prevention of CVD.
Zusatzmaterial
Additional file 1: Table A Cardiovascular risk factor levels according to level of education in the cohort and within sibships in men. Table B Cardiovascular risk factor levels according to level of education in the cohort and within sibships in women. Table C Cardiovascular risk factor levels according to level of education in the cohort and within sibships in sibships discordant for educational level. (DOCX 46 kb)
12889_2017_4123_MOESM1_ESM.docx
Literatur
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