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Trends in educational inequalities in cardiovascular risk factors: A longitudinal study among 48,000 middle-aged Norwegian men and women

  • cardiovascular diseases
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Abstract

The aim of the study was to compare educational and gender specific trends in the classical cardiovascular risk factors body mass index (BMI), cholesterol, systolic blood pressure and smoking in a Norwegian population during a period when the coronary heart disease mortality had just reached its peak in the late 1970s and 1980s. We used The Norwegian Counties study: a longitudinal study with three screenings on the same individuals in Oppland, Sogn␣og Fjordane and Finnmark counties in Norway in the period 1974–1988. All residents aged 35–49 were invited and 48,422 participated (89%) in the baseline screening. To estimate the cardiovascular␣risk factor change in individuals over time longitudinal statistical methods were used. BMI, cholesterol and blood pressure levels increased with age, while the amount of daily smokers decreased. The higher the educational level the lower the level of BMI, blood pressure, smoking and cholesterol. This pattern persisted through the whole study period. In men, however, the educational gradient in cholesterol diminished in the last screening. Among women there was an increase in inequality in systolic blood pressure, and for smoking there was a steeper decrease for men than women across all educational groups. The educational differences in classical cardiovascular risk factors persisted, except for BMI, cholesterol and daily smokers in men which tended to decrease.

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Acknowledgement

This project has been financed with the aid of EXTRA funds from the Norwegian Foundation for Health and Rehabilitation.

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Authors and Affiliations

  1. Division of Epidemiology, Norwegian Institute of Public Health, P.O. Box 4404, NO-0403, Nydalen, Oslo, Norway

    Bjørn Heine Strand & Aage Tverdal

Authors
  1. Bjørn Heine Strand
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  2. Aage Tverdal
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Corresponding author

Correspondence to Bjørn Heine Strand.

Appendix

Appendix

Mortality inequalities for low educated compared to high educated (RII*) in two time periods in three Norwegian counties**, for men and women. Age adjusted RIIs was estimated using Cox-regression.

Time period

RII (95% confidence limits)

Men, 35–49 years

Women, 35–49 years

1970–1980

1.55 (1.26–1.92)

1.68 (1.16–2.42)

1990–2000

3.16 (2.62–3.80)

1.88 (1.42–2.48)

 

Men, 55–69 years

Women, 55–69 years

1990–2000

1.62 (1.47–1.78)

1.97 (1.69–2.30)

  1. *Relative index of inequality as described in [36].
  2. **Oppland, Sogn og Fjordane, Finnmark.

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Strand, B.H., Tverdal, A. Trends in educational inequalities in cardiovascular risk factors: A longitudinal study among 48,000 middle-aged Norwegian men and women. Eur J Epidemiol 21, 731–739 (2006). https://doi.org/10.1007/s10654-006-9046-5

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