Qureshi Adnan I, Suri M Fareed K, Saad Mustafa, Hopkins L Nelson
Department of Neurosurgery and Toshiba Stroke Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, U.S.A.
Med Sci Monit. 2003 Nov;9(11):CR466-73.
Prior reports have suggested that low educational attainment could be associated with higher incidence of some of the cardiovascular conditions.
MATERIAL/METHODS: We evaluated the association of educational attainment (> or =12 years or <12 years) with the incidence of fatal strokes, ischemic stroke, intracerebral hemorrhage, and myocardial infarction in a cohort of 21,443 United States adults who participated in either the First National Health and Nutrition Examination Survey (NHANES-I) Epidemiologic Follow-up Study (NHEFS) or the Second National Health and Nutrition Examination Survey Mortality Follow-up Study (NHANES-II). Cox proportional hazards analyses were used to examine the relationships.
During a mean follow-up period of 15.2+/-4.6 years, the risk for all fatal strokes was increased in persons who reported less than 12 years of education. The increased risk was more prominent in persons aged 50 years or less (relative risk [RR], 2.6; 95% confidence interval [CI], 1.1-6.0) compared with persons aged greater than 50 years (RR, 1.3, 95% CI, 1.0-1.6). A higher risk of myocardial infarction associated with less than 12 years of education was observed in both persons aged 50 years or less (RR 1.7, 95% CI 1.2-2.4) and those aged greater than 50 years (RR 1.3, 95% CI 1.1-1.5). The risk for fatal intracerebral hemorrhages (RR 2.0, 95% CI 1.1-3.5) was higher in persons with less than 12 years of education (no significant interaction demonstrated with age).
Educational attainment has a significant effect on the risk for stroke and myocardial infarction, independent of socioeconomic status and other cardiovascular risk factors.
先前的报告表明，低教育程度可能与某些心血管疾病的较高发病率相关。
材料/方法：我们在一个由21443名美国成年人组成的队列中评估了教育程度（≥12年或<12年）与致命性中风、缺血性中风、脑出血和心肌梗死发病率之间的关联，这些成年人参与了第一次全国健康和营养检查调查（NHANES-I）流行病学随访研究（NHEFS）或第二次全国健康和营养检查调查死亡率随访研究（NHANES-II）。采用Cox比例风险分析来检验这些关系。
在平均15.2±4.6年的随访期内，报告教育年限少于12年的人发生所有致命性中风的风险增加。与年龄大于50岁的人（相对风险[RR]，1.3；95%置信区间[CI]，1.0 - 1.6）相比，这种增加的风险在50岁及以下的人群中更为显著（RR，2.6；95% CI，1.1 - 6.0）。在50岁及以下的人群（RR 1.7，95% CI 1.2 - 2.4）和年龄大于50岁的人群（RR 1.3，95% CI 1.1 - 1.5）中均观察到教育年限少于12年与心肌梗死风险较高相关。教育年限少于12年的人发生致命性脑出血的风险更高（RR 2.0，95% CI 1.1 - 3.5）（未显示与年龄有显著交互作用）。
教育程度对中风和心肌梗死风险有显著影响，独立于社会经济地位和其他心血管危险因素。
