Low income and work stress could be linked to an increased risk of cardiovascular disease, a Danish study published today (17 December 2019) reveals.
The research, the first nationwide analysis of its kind to look at association between education levels and cardiovascular disease found that low income and work stress could explain between 21-54% of the increased risk of developing or dying from cardiovascular disease.
Dr Elisabeth Framke, of the National Research Centre for the Working Environment in Copenhagen, Denmark, analysed data from 1,638,270 Danish residents aged 30 to 59 in 2000 who did not have cardiovascular disease or diabetes at the start of the study.
She and colleagues also looked at 41,944 people who had been diagnosed already with cardiometabolic disease. All participants were followed until the end of 2014 to see who developed or died from these medical conditions.
Writing in the European Heart Journal, they found that of 10,000 men with low educational attainment, 61 developed a cardiovascular disease within 12 months. This compared to 10,000 men with high education, of whom 34 developed the disease in the time-frame.
For women, 32 women out of the 10,000 with low educational attainment developed the disease compared to 16 out of 10,000 who had higher education levels.
The researchers also gathered information on annual disposable household incomes and job strain.
Dr Framke said: “When we took household income level and level of work stress, measured by the combination of high job demands and low job control, into consideration, the increased risk among those with low educational level lessened somewhat. We found a 1.46-fold higher risk among men and 1.53-fold higher risk among women.”
It means adjusting for income and job strain reduced the risk by 25% for men and by 21% for women.
The researchers found a similar pattern when they looked at people who had cardiovascular disease or diabetes when the study started.
“Our interpretation of these findings is that low income and high job strain may play a role in how low educational level affects the risk of developing or dying from cardiovascular disease, but that also a considerable part of this association is independent of income and job strain,” said Dr Framke.
“Furthermore, ensuring equal treatment regardless of educational level is important, both in terms of preventing the development of cardiovascular disease amongst healthy people and of preventing death from cardiovascular disease amongst people who already have heart disease, diabetes or have suffered a stroke.”
Framke E, Sorensen J, Andersen P et al. Contribution of income and job strain to the association between education and cardiovascular disease in 1.6 million Danish employees. European Heart Journal December 2019. doi:10.1093/eurheartj/ehz870
https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehz870
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