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Life Course Socioeconomic Position: Associations with Cardiac Structure and Function at Age 60-64 Years in the 1946 British Birth Cohort

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Listed:
  • Emily T Murray
  • Rebecca Jones
  • Claudia Thomas
  • Arjun K Ghosh
  • Naveed Sattar
  • John Deanfield
  • Rebecca Hardy
  • Diana Kuh
  • Alun D Hughes
  • Peter Whincup

Abstract

Although it is recognized that risks of cardiovascular diseases associated with heart failure develop over the life course, no studies have reported whether life course socioeconomic inequalities exist for heart failure risk. The Medical Research Council’s National Survey of Health and Development was used to investigate associations between occupational socioeconomic position during childhood, early adulthood and middle age and measures of cardiac structure [left ventricular (LV) mass index and relative wall thickness (RWT)] and function [systolic: ejection fraction (EF) and midwall fractional shortening (mFS); diastolic: left atrial (LA) volume, E/A ratio and E/e’ ratio)]. Different life course models were compared with a saturated model to ascertain the nature of the relationship between socioeconomic position across the life course and each cardiac marker. Findings showed that models where socioeconomic position accumulated over multiple time points in life provided the best fit for 3 of the 7 cardiac markers: childhood and early adulthood periods for the E/A ratio and E/e’ ratio, and all three life periods for LV mass index. These associations were attenuated by adjustment for adiposity, but were little affected by adjustment for other established or novel cardio-metabolic risk factors. There was no evidence of a relationship between socioeconomic position at any time point and RWT, EF, mFS or LA volume index. In conclusion, socioeconomic position across multiple points of the lifecourse, particularly earlier in life, is an important determinant of some measures of LV structure and function. BMI may be an important mediator of these associations.

Suggested Citation

  • Emily T Murray & Rebecca Jones & Claudia Thomas & Arjun K Ghosh & Naveed Sattar & John Deanfield & Rebecca Hardy & Diana Kuh & Alun D Hughes & Peter Whincup, 2016. "Life Course Socioeconomic Position: Associations with Cardiac Structure and Function at Age 60-64 Years in the 1946 British Birth Cohort," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-12, March.
    • Handle: RePEc:plo:pone00:0152691
    DOI: 10.1371/journal.pone.0152691
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    References listed on IDEAS

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    1. Kristenson, M. & Eriksen, H. R. & Sluiter, J. K. & Starke, D. & Ursin, H., 2004. "Psychobiological mechanisms of socioeconomic differences in health," Social Science & Medicine, Elsevier, vol. 58(8), pages 1511-1522, April.
    2. Lawlor, D.A. & Davey Smith, G. & Ebrahim, S., 2004. "Association between childhood socioeconomic status and coronary heart disease risk among postmenopausal women. Findings from the British Women's, Heart and Health Study," American Journal of Public Health, American Public Health Association, vol. 94(8), pages 1386-1392.
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