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09-12-2010 | Cardiology | Article

Poor education linked to increased HF risk

Abstract

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MedWire News: Poorly educated individuals have an increased risk for heart dysfunction and chronic heart failure (CHF)-related hospitalization that is independent of other known cardiovascular (CV) risk factors, Danish researchers report.

"Deprivation, as measured by levels of education, should be regarded as a risk factor for CHF in line with what is already known for coronary heart disease (CHD)," said lead researcher Eva Prescott from Bispebjerg University Hospital, Copenhagen.

"Policy makers should be aware of this when planning social and healthcare provision," she added.

Prescott and colleagues analyzed the effect of education on CHF rates among 18,616 men and women enrolled in the Copenhagen City Heart Study, over a median follow-up period of 21 years.

All participants were free of any CHF or myocardial infarction (MI) history at baseline, and were categorized according to their level of education (defined by length of time in school and college): low (<8 years; n=2984), medium (8-10 years; n=2233), and high (>10 years; n=1074).

As reported in the European Heart Journal, 1944 participants were admitted to hospital for CHF during the follow-up period. Of these, 56% had low-level education, 34% had intermediate-level education, and 10% had high-level education. This resulted in a 31% and 48% reduction in risk for CHF admission among participants with intermediate- and high-level education, respectively, compared with those with low-level education (p<0.001).

A randomly selected subgroup of 3589 participants also underwent echocardiography to identify the presence of functional abnormalities associated with CHF, such as left ventricular (LV) hypertrophy, LV dilation, and severe diastolic dysfunction.

After adjustment for CV risk factors, such as smoking and diabetes, individuals with intermediate- and high-level education had a 25% and 39% lower risk for CHF-related functional abnormalities, than those with low-level education (p<0.05 for trend).

"The results presented imply that the socioeconomic gradient in CHF is not only present in advanced stages of disease as measured by hospital admission… but also present already at subclinical stages," say the researchers.

"Further studies are needed to explain the remaining excess just as strategies to reduce this inequality should be strengthened," they conclude.

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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