1Department of Cardiology, Lillebaelt Hospital-Vejle, Denmark.
Scand J Public Health. 2013 Nov;41(7):737-43. doi: 10.1177/1403494813492032. Epub 2013 Jun 5.
Understanding the determinants of social and coping inequalities in subclinical cardiovascular disease is an important prerequisite in developing and implementing preventive strategies. The aim of this study was to investigate the association between social factors and coping status, respectively, and subclinical coronary artery disease (CAD) in middle-aged Danes.
This is a DanRisk screening substudy, thus including healthy Danish males and females aged 50 or 60 years. Social measures included grade of education, employment and co-habiting status. The coping status was estimated by the general self-efficacy (GES) scale. Coronary artery calcification (CAC) was assessed by computed tomography using the Agatston score (AS). Conventional clinical risk factors included sex, family history of CAD, BMI > 25, smoking, hypercholesterolaemia and hypertension.
In 568 individuals the prevalence of subjects with CAC was 267 (45%). Independent predictors of CAC in males were age (OR = 1.10, 95% CI = 1.04-1.16, p < 0.001), smoking (OR = 1.75, 95% CI = 1.03-2.99, p = 0.038), and low co-habiting status (OR = 3.66, 95% CI = 1.19-11.25, p = 0.023). Independent predictors in females were age (OR = 1.67, 95% CI = 1.02-1.12, p = 0.006), and smoking (OR = 1.71, 95% CI = 1.06-2.78, p = 0.029). Higher AS was associated to lower employment level in females (p = 0.001) but not in males (p = 0.833).
Social factors are associated to the prevalence and severity of CAC in asymptomatic middle-aged individuals with gender differences. The relative value of gender specific social versus conventional clinical risk factors in the risk assessment of subclinical CAC in middle-aged individuals needs further investigation in future prospective studies.
了解亚临床心血管疾病中社会和应对不平等的决定因素，是制定和实施预防策略的重要前提。本研究旨在探讨社会因素和应对状态与中年丹麦人亚临床冠状动脉疾病（CAD）之间的关系。
这是一项丹风险筛查子研究，因此包括 50 岁或 60 岁的健康丹麦男性和女性。社会措施包括教育程度、就业状况和同居状况。应对状态由一般自我效能感（GES）量表来评估。冠状动脉钙化（CAC）通过计算机断层扫描使用 Agatston 评分（AS）进行评估。常规临床危险因素包括性别、CAD 家族史、BMI>25、吸烟、高胆固醇血症和高血压。
在 568 名参与者中，有 CAC 的患者占 267 例（45%）。男性 CAC 的独立预测因素为年龄（OR=1.10，95%CI=1.04-1.16，p<0.001）、吸烟（OR=1.75，95%CI=1.03-2.99，p=0.038）和低同居状态（OR=3.66，95%CI=1.19-11.25，p=0.023）。女性的独立预测因素为年龄（OR=1.67，95%CI=1.02-1.12，p=0.006）和吸烟（OR=1.71，95%CI=1.06-2.78，p=0.029）。较高的 AS 与女性较低的就业水平相关（p=0.001），但与男性无关（p=0.833）。
社会因素与无症状中年个体 CAC 的患病率和严重程度有关，且存在性别差异。在未来的前瞻性研究中，需要进一步研究性别特异性社会与常规临床危险因素在中年个体亚临床 CAC 风险评估中的相对价值。
