Hart C L, Hole D J, Smith G D
Department of Public Health, University of Glasgow, Glasgow, UK.
Stroke. 2000 Sep;31(9):2093-7. doi: 10.1161/01.str.31.9.2093.
The purpose of the study was to investigate stroke risk by socioeconomic measures.
The analysis was based on a large cohort study of 5765 working men, from 27 workplaces in Scotland, who were screened between 1970 and 1973. Stroke was defined as having a hospital admission with a main diagnosis of stroke or dying of stroke in the 25-year follow-up period.
There were 416 men who had a stroke. Men with manual occupations when screened, on first entering the workforce, men with manual occupations, and men whose fathers had manual occupations had significantly higher rates of stroke than men in the nonmanual categories. Men who left full-time education at age 16 years or under also had significantly higher rates of stroke. Men living in more deprived areas had higher rates of stroke, but the rates were not statistically significant. The most marked difference was in relation to father's social class, and although adjusting for risk factors for stroke attenuated the relative rates, men whose fathers were in manual social classes had higher relative rates of stroke than men whose fathers were in nonmanual classes (adjusted relative rate for father's social class III manual was 1.37 [95% CI 1.03 to 1.81] and for father's social class IV or V was 1.46 [1.09 to 1.96]). Men who were upwardly mobile (father's social class manual, own social class nonmanual) had a rate of stroke similar to that of stable manual men.
Poorer socioeconomic circumstance was associated with greater stroke risk, with adverse early-life circumstances of particular importance.
本研究旨在通过社会经济指标调查中风风险。
分析基于一项对5765名在职男性的大型队列研究，这些男性来自苏格兰的27个工作场所，于1970年至1973年期间接受筛查。中风定义为在25年随访期内因主要诊断为中风而住院或死于中风。
有416名男性发生中风。筛查时从事体力劳动的男性、刚进入劳动力市场时从事体力劳动的男性、从事体力劳动的男性以及父亲从事体力劳动的男性，其中风发生率显著高于非体力劳动类别的男性。16岁及以下辍学的男性中风发生率也显著更高。生活在贫困地区的男性中风发生率较高，但差异无统计学意义。最显著的差异与父亲的社会阶层有关，尽管对中风风险因素进行调整后相对发生率有所降低，但父亲属于体力劳动社会阶层的男性中风相对发生率高于父亲属于非体力劳动社会阶层的男性（父亲社会阶层为III体力劳动的调整后相对发生率为1.37[95%CI 1.03至1.81]，父亲社会阶层为IV或V的调整后相对发生率为1.46[1.09至1.96]）。社会阶层上升的男性（父亲社会阶层为体力劳动，自身社会阶层为非体力劳动）中风发生率与稳定的体力劳动者相似。
社会经济状况较差与中风风险增加相关，早期不良生活环境尤为重要。
