Abstract
BackgroundEpidemiological evidence for the relationship between education and income and carotid intima-media thickness (CIMT) has been limited and inconsistent. The present cross-sectional study investigated this issue using baseline data from the Aidai Cohort Study.MethodsStudy subjects were 2012 Japanese men and women aged 34−88 years. Right and left CIMT were measured at the common carotid artery using an automated carotid ultrasonography device. Maximum CIMT was defined as the largest CIMT value in either the left or right common carotid artery. Carotid wall thickening was defined as a maximum CIMT value > 1.0 mm.ResultsThe prevalence of carotid wall thickening was 13.0%. In participants under 60 years of age (n = 703) and in those aged 60 to 69 years (n = 837), neither education nor household income was associated with carotid wall thickening or with maximum CIMT. Among those aged 70 years or older (n = 472), however, higher educational level, but not household income, was independently related to a lower prevalence of carotid wall thickening: the multivariate-adjusted odds ratio for high vs. low educational level was 0.43 (95% confidence interval 0.21−0.83, p for trend = 0.01). A significant inverse association was observed between education, but not household income, and maximum CIMT (p for trend = 0.006).ConclusionsHigher educational level may be associated with a lower prevalence of carotid wall thickening and a decrease in maximum CIMT only in participants aged 70 years or older.
Highlights
Ischemic heart disease and stroke are the first and second leading causes of death, responsible for approximately 16% and 11%, respectively, of the world’s total deaths [1]
The geometric mean of the maximum carotid intimamedia thickness (CIMT) for the population was 0.783 mm
When study subjects were classified into three age groups (< 60, 60−69, and ≥ 70 years), neither education nor household income was associated with carotid wall thickening or the maximum CIMT among study subjects under 60 years of age or among those aged 60 to 69 years in the multivariate model
Summary
Ischemic heart disease and stroke are the first and second leading causes of death, responsible for approximately 16% and 11%, respectively, of the world’s total deaths [1]. The main underlying cause of cardiovascular disease (CVD) is atherosclerosis, and imaging protocols for subclinical atherosclerosis such as carotid ultrasound measurements of carotid intima-media thickness (CIMT) may improve our ability to assess an individual’s risk of future CVD [2]. Several epidemiological studies have investigated the relationship between socioeconomic status, education and income, and CIMT, but their results have been inconsistent [4,5,6,7,8,9,10,11,12], and epidemiological evidence on this issue is lacking in Japan. The present cross-sectional study investigated the association of education and household income with carotid wall thickening and maximum CIMT in middle-aged and older Japanese individuals using baseline data from the Aidai Cohort Study (AICOS) conducted in Yawatahama, Uchiko, Seiyo, and Ainan. The present cross-sectional study investigated this issue using baseline data from the Aidai Cohort Study
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