BMJ  2004;328:861 (10 April), doi:10.1136/bmj.38034.702836.55 (published 8 March 2004)

Paper

Clustering of risk factors and social class in childhood and adulthood in British women's heart and health study: cross sectional analysis

¹ Department of Social Medicine, University of Bristol, Canynge Hall, Bristol BS8 2PR

Objective To examine co-occurrence and clustering of risk factors used in the Framingham equation by social class in childhood and adult life.

Design Cross sectional study.

Setting 23 towns across England, Wales, and Scotland.

Participants 2936 women aged 60-79 years.

Main outcome measures Prevalence of risk factors (hypertension, obesity, smoking, left ventricular hypertrophy on electrocardiography, diabetes, and low concentration of high density cholesterol); ratios of observed to expected frequencies of clusters of risk factors.

Results Risk factors were more common in women from manual social classes in either childhood or adult life, and the co-occurrence of three or four of these risk factors was greater among more disadvantaged groups. Within the four socioeconomic groups, these risk factors occurred together more than would be expected from their individual frequency distributions, indicating that they were clustered. The extent of this clustering was similar in all four social class groups.

Conclusions Clustering of risk factors included in the Framingham risk function occurs in all social class groups, but the lack of social patterning makes it unlikely that clustering is an explanation of socioeconomic inequalities in cardiovascular disease. As the proportion of women with co-occurrence of risk factors is greatest in those from manual social class in childhood, this measure of socioeconomic position might prove useful in risk prediction.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Related Articles

Recruiting patients to medical research: double blind randomised trial of "opt-in" versus "opt-out" strategies

Cornelia Junghans, Gene Feder, Harry Hemingway, Adam Timmis, and Melvyn Jones
BMJ 2005 331: 940. [Abstract] [Full Text] [PDF]

Clustering of common risk factors does not explain risk of CHD
BMJ 2004 328: 0. [Full Text]

This article has been cited by other articles:

• Kivimaki, M., Lawlor, D. A., Smith, G. D., Kouvonen, A., Virtanen, M., Elovainio, M., Vahtera, J. (2007). KIVIMAKI ET AL. RESPOND. Am. J. Public Health 97: 1928-1929 [Full text]  
• Kivimaki, M., Lawlor, D. A., Smith, G. D., Kouvonen, A., Virtanen, M., Elovainio, M., Vahtera, J. (2007). Socioeconomic Position, Co-Occurrence of Behavior-Related Risk Factors, and Coronary Heart Disease: the Finnish Public Sector Study. Am. J. Public Health 97: 874-879 [Abstract] [Full text]  
• Ljung, R, Hallqvist, J (2006). Accumulation of adverse socioeconomic position over the entire life course and the risk of myocardial infarction among men and women: results from the Stockholm Heart Epidemiology Program (SHEEP).. J. Epidemiol. Community Health 60: 1080-1084 [Abstract] [Full text]  
• Chittleborough, C R, Baum, F E, Taylor, A W, Hiller, J E (2006). A life-course approach to measuring socioeconomic position in population health surveillance systems.. J. Epidemiol. Community Health 60: 981-992 [Abstract] [Full text]  
• Lawlor, D. A., O'Callaghan, M. J., Mamun, A. A., Williams, G. M., Bor, W., Najman, J. M. (2005). Socioeconomic Position, Cognitive Function, and Clustering of Cardiovascular Risk Factors in Adolescence: Findings From the Mater University Study of Pregnancy and Its Outcomes. Psychosom. Med. 67: 862-868 [Abstract] [Full text]  
• Junghans, C., Feder, G., Hemingway, H., Timmis, A., Jones, M. (2005). Recruiting patients to medical research: double blind randomised trial of "opt-in" versus "opt-out" strategies. BMJ 331: 940- [Abstract] [Full text]  
• Alharbi, K. K., Aldahmesh, M. A., Spanakis, E., Haddad, L., Whittall, R. A., Chen, X.-h., Rassoulian, H., Smith, M. J., Sillibourne, J., Ball, N. J., Graham, N. J., Briggs, P. J., Simpson, I. A., Phillips, D. I.W., Lawlor, D. A., Ye, S., Humphries, S. E., Cooper, C., Smith, G. D., Ebrahim, S., Eccles, D. M., Day, I. N.M. (2005). Mutation scanning by meltMADGE: Validations using BRCA1 and LDLR, and demonstration of the potential to identify severe, moderate, silent, rare, and paucimorphic mutations in the general population. Genome Res. 15: 967-977 [Abstract] [Full text]  

Rapid Responses:

Read all Rapid Responses

Perm any 3 from 10; but who's the winner?

GH Hall
bmj.com, 11 Apr 2004 [Full text]

Why are there no Framingham scores, and why the high threshold for hypertension?

Michael J White
bmj.com, 26 Apr 2004 [Full text]