Department of Critical Care Medicine, Zhuhai People's Hospital (Zhuhai Hospital affiliated with Jinan University), Zhuhai, 519000, Guangdong, China.
Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Road, Lubei District, Tangshan, 063000, China.
BMC Public Health. 2024 Oct 4;24(1):2709. doi: 10.1186/s12889-024-20205-5.
We aimed to explore the association of socioeconomic status (SES) and life's essential 8 (LE8) with cardiovascular disease (CVD) and all-cause mortality in north China.
A total of 91,365 adults from the Kailuan study were included in this study. Comprehensive individual SES, mainly including monthly household income, education, Occupation position, and community environment, was confirmed by latent class analysis. Furthermore, the mediation and combination effects of SES and LE8 on CVD and all-cause mortality were further assessed. The Cox regression model was conducted to estimate HRs and 95% CI.
During about 13 years of follow-up, 7,646 cardiovascular events and 11,749 deaths were recorded. Relative to the high SES, there were decreased risks of CVD [HR (95% CI): 1.57(1.43-1.72)] and high all-cause death [HR (95% CI): 1.43(1.31-1.53)] in the low SES. The associations between SES and CVD [Mediation % (95% CI): 22.3 (16.4-30.4)] and mortality [Mediation % (95% CI): 10.1 (7.1-14.0)] were partially mediated by LE8 when comparing medium SES to high SES. Meanwhile, relative to high LE8, the elevated risk of death [HR (95% CI): 1.72(1.56-1.89)], and incident CVD [HR (95% CI): 3.34(2.91-3.83)] were detected in low LE8. Compared to participants who had the high SES and LE8, participants who had both the low SES and LE8 further increased the risk of CVD [HR (95% CI): 7.76(5.21-11.55)] and all-cause mortality [HR (95% CI): 2.80(2.19-3.58)].
Low SES was related to a higher risk of CVD and mortality in low- and middle-income countries, which was partially mediated by LE8.
本研究旨在探讨中国北方地区社会经济地位（SES）和生活的基本 8 项指标（LE8）与心血管疾病（CVD）和全因死亡率之间的关系。
本研究共纳入了 91365 名来自开滦研究的成年人。通过潜在类别分析确定了综合个体 SES，主要包括月家庭收入、教育程度、职业地位和社区环境。此外，还进一步评估了 SES 和 LE8 对 CVD 和全因死亡率的中介和组合效应。采用 Cox 回归模型估计 HRs 和 95%CI。
在大约 13 年的随访期间，共记录了 7646 例心血管事件和 11749 例死亡。与高 SES 相比，低 SES 人群患 CVD 的风险降低[HR（95%CI）：1.57（1.43-1.72）]，全因死亡风险也降低[HR（95%CI）：1.43（1.31-1.53）]。SES 与 CVD[中介百分比（95%CI）：22.3（16.4-30.4）]和死亡率[中介百分比（95%CI）：10.1（7.1-14.0）]之间的关联部分是由 LE8 介导的，将中 SES 与高 SES 进行比较时。同时，与高 LE8 相比，低 LE8 组的死亡风险增加[HR（95%CI）：1.72（1.56-1.89）]和新发 CVD[HR（95%CI）：3.34（2.91-3.83）]。与 SES 和 LE8 均较高的参与者相比，SES 和 LE8 均较低的参与者患 CVD 的风险进一步增加[HR（95%CI）：7.76（5.21-11.55）]和全因死亡率[HR（95%CI）：2.80（2.19-3.58）]。
在中低收入国家，低 SES 与 CVD 和死亡率风险增加有关，部分原因是 LE8 所致。
