People with minimal education are more likely to develop heart failure than others – even if they have similar lifestyles, according to the findings of a major European study today.
The findings suggest that better educated people are more successful than others at getting early treatment to stave off heart disease.
They may also reflect differences in quality of care between Europe’s rich and poor nations.
Researchers say the difference in risk is stark – someone with an education lasting ten years or more is 39 per cent less likely to show signs of early heart failure than someone who has received less than eight years of education.
During their analysis they eliminated factors such as smoking, diet, weight and fitness as being responsible for the difference.
The findings, in the European Heart Journal, come from an analysis of more than 18,000 people over 31 years.
People who took part received regular echocardiography – and this was used as a way of diagnosing heart failure.
Researcher Professor Eva Prescott, of Bispebjerg University Hospital, Copenhagen, Denmark, said: "Although it is well known that socioeconomic deprivation is associated with coronary heart disease, much less is known about the link with the development of chronic heart failure.
"There are two important findings from this study. The first is that the clear socioeconomic gradient in risk of developing heart failure found in this and in other studies is not explained by differences in lifestyle.
"Thus, we must look for other explanations, which potentially include differences in treatment of patients; for instance, perhaps the socioeconomically deprived do not receive the same standard of treatment as the more affluent."
Amy Thompson, of the British Heart Foundation, said the findings might reflect whether people heard health promotion messages.
She said: "In this study the risk factors for heart disease, such as high blood pressure, did not fully account for the excess risk of heart failure. The findings are certainly interesting and further research is needed to try and explain these results.
"It does remind us just how important health promotion is from an early age. It helps to raise awareness of heart disease risk factors and shows us there are a number of ways we can all try to lead a healthier lifestyle to protect our hearts."
Level of education and risk of heart failure: a prospective cohort study with echocardiography evaluation. Stefan Christensen, Rasmus Mogelvang, Merete Heitmann, and Eva Prescott. European Heart Journal. doi:10.1093/eurheartj/ehq435
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