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13-07-2010 | Cardiology | Article

Neighborhood, social cohesion affects women’s subclinical CV risk

Abstract

Free abstract

MedWire News: A US study reports that high levels of neighborhood deprivation and low levels of neighborhood cohesion are independent risk factors for coronary artery calcification (CAC) in women.

Lead researcher Daniel Kim (Harvard School of Public Health, Boston, Massachusetts) told MedWire News that, by contrast, "the neighborhood associations in men were less generalized, with low neighborhood cohesion only appearing to have effects for men living in poor (and not rich) neighborhoods."

He explained that these gender differences "may be related to the greater time that women may spend within their neighborhoods due to gender roles."

In 2000, the researchers examined the level of deprivation and social cohesion within the neighborhoods of 2974 participants (1275 male, 1699 female, average age 45.3 years). Five years later they measured the CAC rates within the same population.

Neighborhood deprivation was assessed by socioeconomic predictor (SEP) scores based on variables reflecting income/wealth, such as level of education and current occupation of household occupants. High SEP scores reflected low neighborhood deprivation, and vice-versa.

Neighborhood cohesion was measured by gauging each participant's perception of camaraderie among themselves and their neighbors.

By 2005, 533 participants had developed CAC, with a lower prevalence among women than men, at 10.9% versus 28.9%.

The women in the highest quartile of neighborhood deprivation had a 2.5-fold increased risk for CAC compared with those in the lowest quartile (p=0.03). Similarly, the women in the lowest quartile for neighborhood cohesion had a 1.87-fold increased risk for CAC compared with those in the highest quartile (p=0.02). These trends remained even after adjustment for sociodemographic, socioeconomic, and biologic characteristics such as income and occupation, and coronary disease risk factors such as smoking and physical inactivity.

The women in the lowest quartile for neighborhood cohesion also had an increased risk for CAC irrespective of the level of neighborhood deprivation. However, in men, the lowest quartile for neighborhood cohesion had a 3-fold increase in CAC risk, for deprived neighborhoods only, compared with the highest quartile for neighborhood cohesion.

The researchers conclude: "This study offers novel evidence on the association of neighborhood deprivation and low cohesion with CAC in younger asymptomatic adults."

They add: "Future investigations should build on these findings, including gender differences and mediating pathways, to better elucidate the contextual and individual-level determinants of coronary heart disease and thereby optimize the design of effective prevention strategies."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Lauretta Ihonor

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