Iribarren C, Luepker R V, McGovern P G, Arnett D K, Blackburn H
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, USA.
Arch Intern Med. 1997 Apr 28;157(8):873-81.
Inverse associations of educational level and household income (as proxy indicators of socioeconomic status) with cardiovascular disease risk factors are fairly well established. Whether differences in cardiovascular disease risk factors across education or income levels have widened in the last decade remains an issue of considerable public health importance.
Analysis by mixed-regression models of trends in cardiovascular disease risk factors, in population-based samples (n = 3334 in 1980-1982, n = 4538 in 1985-1987, and n = 4517 in 1990-1992) of Minneapolis-St Paul residents 25 to 74 years old.
Education level was inversely related to serum cholesterol level, systolic blood pressure, smoking prevalence, and body mass index and positively related to leisure-time physical activity and health knowledge in both sexes. Household income was inversely associated with systolic blood pressure and body mass index in women and with smoking prevalence in both sexes. Income level was positively associated with leisure-time physical activity and health knowledge in both sexes. There were overall favorable downward secular trends in serum cholesterol level and systolic blood pressure, favorable upward trends in health knowledge, and unfavorable upward trends in body mass index across all socioeconomic status groups. Throughout the decade, trends in smoking prevalence differed by education level in men (P = .01), such that declines were observed only in those with a college degree or some college education. With respect to trends in leisure-time physical activity, there were greater gains among men with low socioeconomic status (P = .03 for education; P = .02 for income) and among less affluent women (P = .001).
These data support the inverse association between socioeconomic status and cardiovascular disease risk factors but suggest no widening (with the exception of smoking by education level in men) of socioeconomic differences in risk factor trends during the last decade in a representative sample of the Minneapolis-St Paul population.
教育水平和家庭收入（作为社会经济地位的代理指标）与心血管疾病风险因素之间的负相关关系已得到相当充分的确立。在过去十年中，不同教育或收入水平人群的心血管疾病风险因素差异是否有所扩大，仍是一个具有相当公共卫生重要性的问题。
采用混合回归模型，对明尼阿波利斯 - 圣保罗市25至74岁居民的基于人群的样本（1980 - 1982年n = 3334，1985 - 1987年n = 4538，1990 - 1992年n = 4517）中心血管疾病风险因素的趋势进行分析。
教育水平与血清胆固醇水平、收缩压、吸烟率和体重指数呈负相关，与男女的休闲体育活动和健康知识呈正相关。家庭收入与女性的收缩压和体重指数呈负相关，与男女的吸烟率呈负相关。收入水平与男女的休闲体育活动和健康知识呈正相关。在所有社会经济地位组中，血清胆固醇水平和收缩压总体呈有利的下降长期趋势，健康知识呈有利的上升趋势，体重指数呈不利的上升趋势。在整个十年中，男性吸烟率的趋势因教育水平而异（P = 0.01），只有大学学历或接受过一些大学教育的男性吸烟率有所下降。关于休闲体育活动的趋势，社会经济地位低的男性（教育程度P = 0.03；收入P = 0.02）和较不富裕的女性（P = 0.001）的增加幅度更大。
这些数据支持社会经济地位与心血管疾病风险因素之间的负相关关系，但表明在明尼阿波利斯 - 圣保罗市人口的代表性样本中，过去十年风险因素趋势的社会经济差异没有扩大（男性按教育水平划分的吸烟情况除外）。
