Chronic disease in former college students. XVII. Sociocultural mobility as a precursor of coronary heart disease and hypertension.

The relationship between sociocultural mobility and subsequent coronary heart disease (CHD) and hypertension (HT) was studied in a cohort of 13,728 male former Harvard University students examined in 1939-1950. All 13,728 were followed for CHD mortality, while 8852 returned self-administered mail questionnaires in 1962 or 1966 and in 1972 which queried for doctor-diagnosed myocardial infarction (MI), angina pectoris (AP) and HT. For each of 98 cases of fatal CHD, 78 cases of MI and 48 cases of AP, four controls were randomly selected. One control was selected for each of 319 HT cases. Significant negative associations between father's occupational status and risk of combined fatal CHD and MI and between geographic mobility and risk of HT were noted in univariate analysis. These associations persisted with stratification by individual confounding factors and by a multivariate confounder-summarizing score. Intergenerational mobility, as indicated by occupational status of the father, was associated with a 1.5 times increased risk of fatal CHD and MI. Intragenerational geographic mobility was associated with a slightly reduced risk of HT.