Social class differences in secular trends in established coronary risk factors over 20 years: a cohort study of British men from 1978-80 to 1998-2000

Coronary heart disease (CHD) mortality in the UK since the late 1970s has declined more markedly among higher socioeconomic groups. However, little is known about changes in coronary risk factors in different socioeconomic groups. This study examined whether changes in established coronary risk fact...

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Bibliographic Details
Published in:	PloS one 2011-05, Vol.6 (5), p.e19742-e19742
Main Authors:	Ramsay, Sheena E, Whincup, Peter H, Hardoon, Sarah L, Lennon, Lucy T, Morris, Richard W, Wannamethee, S G
Format:	Article
Language:	eng
Subjects:	Adult Automation Biology Blood cholesterol Blood pressure Body mass Body Mass Index Body size Body weight Cardiovascular disease Cardiovascular diseases Cholesterol Cholesterol - blood Cigarette smoking Cigarettes Class differences Cohort analysis Cohort Studies Coronary artery disease Coronary Disease - epidemiology Coronary Disease - etiology Coronary heart disease Diabetes Diabetes mellitus Diabetes Mellitus, Type 2 - epidemiology Diabetes Mellitus, Type 2 - etiology Disadvantaged Disadvantaged groups Enzymes Follow-Up Studies Health aspects Health disparities Health risk assessment Health risks Heart Heart diseases High density lipoprotein Humans Lipoproteins Male Medical research Medicine Medicine, Experimental Men Mens health Middle age Middle Aged Minority groups Mortality Occupations Polyethylene glycol Population Primary care Risk analysis Risk Factors Smoking Social Class Social classes Socioeconomic factors Socioeconomic status Socioeconomics Trends Type 2 diabetes United Kingdom
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Summary:	Coronary heart disease (CHD) mortality in the UK since the late 1970s has declined more markedly among higher socioeconomic groups. However, little is known about changes in coronary risk factors in different socioeconomic groups. This study examined whether changes in established coronary risk factors in Britain over 20 years between 1978-80 and 1998-2000 differed between socioeconomic groups. A socioeconomically representative cohort of 7735 British men aged 40-59 years was followed-up from 1978-80 to 1998-2000; data on blood pressure (BP), cholesterol, body mass index (BMI) and cigarette smoking were collected at both points in 4252 survivors. Social class was based on longest-held occupation in middle-age. Compared with men in non-manual occupations, men in manual occupations experienced a greater increase in BMI (mean difference = 0.33 kg/m(2); 95%CI 0.14-0.53; p for interaction = 0.001), a smaller decline in non-HDL cholesterol (difference in mean change = 0.18 mmol/l; 95%CI 0.11-0.25, p for interaction≤0.0001) and a smaller increase in HDL cholesterol (difference in mean change = 0.04 mmol/l; 95%CI 0.02-0.06, p for interaction≤0.0001). However, mean systolic BP declined more in manual than non-manual groups (difference in mean change = 3.6; 95%CI 2.1-5.1, p for interaction≤0.0001). The odds of being a current smoker in 1978-80 and 1998-2000 did not differ between non-manual and manual social classes (p for interaction = 0.51). Several key risk factors for CHD and type 2 diabetes showed less favourable changes in men in manual occupations. Continuing priority is needed to improve adverse cardiovascular risk profiles in socially disadvantaged groups in the UK.
ISSN:	1932-6203 1932-6203