Power C, Atherton K, Manor O
Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
J Epidemiol Community Health. 2008 Dec;62(12):1030-5. doi: 10.1136/jech.2007.068817.
To establish whether social differences in multiple risk factors for cardiovascular disease are due to a greater strength of association (higher correlation) between risk factors in less advantaged groups.
Co-occurrence of five risk factors (smoking, hypertension, low high-density lipoprotein cholesterol, obesity, diabetes) in 3614 British 45-year-old men and 3560 women in the manual and non-manual social groups.
4.0% of women in manual groups had >or=3 risk factors compared with 1.7% in non-manual groups: 6.2% and 3.4% respectively for men. There was a higher than expected percentage of the population, overall, with >or=3 risk factors assuming independence between risk factors; correspondingly, there was a slightly lower than expected proportion with one factor. However, patterns of observed to expected ratios were consistent in manual and non-manual groups and did not differ by the number of risk factors.
Higher prevalence of multiple risk factors in manual groups was due to the higher prevalence of individual factors rather than a greater tendency of those with an individual risk factor to have additional risks. Strategies to reduce multiple risk factors in less advantaged groups would help to lessen their health burden.
确定心血管疾病多种危险因素的社会差异是否归因于弱势群体中危险因素之间更强的关联强度(更高的相关性)。
对3614名英国45岁男性和3560名从事体力劳动和非体力劳动社会群体的女性中的五种危险因素(吸烟、高血压、低高密度脂蛋白胆固醇、肥胖、糖尿病)的共现情况进行研究。
体力劳动群体中4.0%的女性有≥3种危险因素,而非体力劳动群体中这一比例为1.7%;男性的相应比例分别为6.2%和3.4%。总体而言,假设危险因素之间相互独立,有≥3种危险因素的人群比例高于预期;相应地,有一种危险因素的人群比例略低于预期。然而,体力劳动和非体力劳动群体中观察到的与预期比例的模式是一致的,且不因危险因素的数量而有所不同。
体力劳动群体中多种危险因素的较高患病率是由于个体因素的较高患病率,而非有个体危险因素者有额外危险因素的更大倾向。降低弱势群体中多种危险因素的策略将有助于减轻他们的健康负担。