Rosengren A, Wedel H, Wilhelmsen L
Department of Medicine, Ostra Hospital, Gothenburg University, Sweden.
BMJ. 1988 Dec 10;297(6662):1497-500. doi: 10.1136/bmj.297.6662.1497.
In the Gothenburg primary prevention study 7083 middle aged men were classified into five categories by occupational state. A retrospective analysis of the data showed that low occupational class was associated with slight increases in smoking rates, systolic blood pressure, serum cholesterol concentration, body mass index, and heart rate. Alcohol abuse was strongly associated with low occupational class. After a mean of 11.8 years' follow up the incidence of coronary heart disease was found to be strongly and inversely related to occupational class. For death from coronary heart disease this association fell just below significance when other risk factors were taken into account, but the inverse association between non-fatal myocardial infarction and occupational class persisted even in multivariate analysis. A weak but independent inverse relation was found between occupational class and fatal cancer. Mortality from all causes in the lowest occupational class was 12% compared with 6% in the highest class, and this difference could only partly be explained by other factors. After 10 years a sub-sample of the men were examined again. Risk factors had decreased in all occupational classes, but the changes in risk were not associated with occupational class. Social class, defined by occupation, in Sweden is clearly related to the incidence of coronary heart disease.
在哥德堡初级预防研究中，7083名中年男性按职业状况分为五类。对数据的回顾性分析表明，低职业阶层与吸烟率、收缩压、血清胆固醇浓度、体重指数和心率的轻微升高有关。酗酒与低职业阶层密切相关。经过平均11.8年的随访，发现冠心病的发病率与职业阶层密切相关且呈负相关。对于冠心病死亡，在考虑其他危险因素时，这种关联略低于显著水平，但即使在多变量分析中，非致命性心肌梗死与职业阶层之间的负相关仍然存在。发现职业阶层与致命癌症之间存在微弱但独立的负相关关系。最低职业阶层的全因死亡率为12%，而最高职业阶层为6%，这种差异只能部分由其他因素解释。10年后，对这些男性的一个子样本再次进行检查。所有职业阶层的危险因素都有所下降，但危险因素的变化与职业阶层无关。在瑞典，由职业定义的社会阶层显然与冠心病的发病率有关。
