Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Educational inequality in cardiovascular diseases: a sibling approach

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Role of disease and demographic factors as determinants of return migration: A nationwide register-based cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Criterion validity of the Physical Activity Scale (PAS2) in Danish adults

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Maternal fertility problems and risk for transient neonatal diabetes mellitus

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. National study of the prevalence of gestational diabetes mellitus among Danish women from 2004 to 2012

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Young adult cognitive ability and subsequent major depression in a cohort of 666,804 Danish men

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Should benzodiazepines be avoided?

    Research output: Contribution to journalEditorialResearchpeer-review

  3. Incidence of, Risk Factors for, and Changes Over Time in Treatment-Resistant Depression in Denmark: A Register-Based Cohort Study

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Data Resource Profile: Danish Conscription Registry Data (DCRD)

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Change in Overweight from Childhood to Early Adulthood and Risk of Type 2 Diabetes

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

AIMS: Educational inequality in diseases in the circulatory system (here termed cardiovascular disease) is well documented but may be confounded by early life factors. The aim of this observational study was to examine whether the associations between education and all cardiovascular diseases, ischaemic heart disease and stroke, respectively, were explained by family factors shared by siblings.

METHODS: The study population included all individuals born in Denmark between 1950 and 1979 who had at least one full sibling born in the same period. Using Cox regression, data were analysed in conventional cohort and within-sibship analyses in which the association was examined within siblings discordant on education. Assuming that attenuation of associations in the within-sibship as compared with the cohort analyses would indicate confounding from factors shared within families.

RESULTS: A lower educational status was associated with a higher risk of cardiovascular disease, ischaemic heart disease and stroke. All associations attenuated in the within-sibship analyses, in particular in the analyses on ischaemic heart disease before age 45 years. For instance, in the cohort analyses, the hazard rate of ischaemic heart disease among women less than 45 years who had a primary school education was 94% (hazard ratio 1.94 (1.78-2.12) higher than among those with a vocational education, while it attenuated to 51% (hazard ratio 1.51 (1.34-1.71)) in the within-sibship analysis.

CONCLUSIONS: Confounding from factors shared by siblings explained the associations between education and the cardiovascular disease outcomes but to varying degrees. This should be taken into account when planning interventions aimed at reducing educational inequalities in the development of cardiovascular disease, ischaemic heart disease and stroke.

Original languageEnglish
JournalScandinavian Journal of Public Health
Volume46
Issue number1
Pages (from-to)83-91
ISSN1403-4948
DOIs
Publication statusPublished - 2018

    Research areas

  • Journal Article

ID: 52397603