Are the educational differences in incidence of cardiovascular disease explained by underlying familial factors? A twin study

TY - JOUR

T1 - Are the educational differences in incidence of cardiovascular disease explained by underlying familial factors?

T2 - A twin study

AU - Madsen, Mia

AU - Andersen, Per Kragh

AU - Gerster, Mette

AU - Andersen, Anne-Marie Nybo

AU - Christensen, Kaare

AU - Osler, Merete

N1 - Copyright © 2014 Elsevier Ltd. All rights reserved.

PY - 2014/10

Y1 - 2014/10

N2 - To isolate the effect of education from the influence of potential underlying factors, we investigated the association of education with the risk of cardiovascular disease (CVD) and ischemic heart disease (IHD) using twin data to adjust for familial factors shared within twins, including genetic make-up and childhood environment. The study was based on data from the Danish Twin Registry linked to administrative and heath registers in Statistics Denmark. A total of 11,968 monozygotic and 20,464 dizygotic same sexed twins were followed from 1980 to 2009, including more than 8000 events of CVD. Unpaired and intra-pair analyses were compared. In the unpaired analyses, an inverse educational gradient in CVD- and IHD risk was observed. This association was not replicated in the intra-pair analyses that control for shared familial factors exploiting that twins share their intrauterine- and childhood environment and are matched partly or fully on genetic setup. The attenuation of association of education with CVD and IHD in the intra-pair analyses suggests that shared familial factors account for a substantial part of the observed association of education with CVD and IHD in Denmark.

AB - To isolate the effect of education from the influence of potential underlying factors, we investigated the association of education with the risk of cardiovascular disease (CVD) and ischemic heart disease (IHD) using twin data to adjust for familial factors shared within twins, including genetic make-up and childhood environment. The study was based on data from the Danish Twin Registry linked to administrative and heath registers in Statistics Denmark. A total of 11,968 monozygotic and 20,464 dizygotic same sexed twins were followed from 1980 to 2009, including more than 8000 events of CVD. Unpaired and intra-pair analyses were compared. In the unpaired analyses, an inverse educational gradient in CVD- and IHD risk was observed. This association was not replicated in the intra-pair analyses that control for shared familial factors exploiting that twins share their intrauterine- and childhood environment and are matched partly or fully on genetic setup. The attenuation of association of education with CVD and IHD in the intra-pair analyses suggests that shared familial factors account for a substantial part of the observed association of education with CVD and IHD in Denmark.

U2 - 10.1016/j.socscimed.2014.04.016

DO - 10.1016/j.socscimed.2014.04.016

M3 - Comment/debate

C2 - 24768271

SN - 0277-9536

VL - 118

SP - 182

EP - 190

JO - Social Science & Medicine

JF - Social Science & Medicine

ER -