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Association of cardiovascular disease risk factors with socioeconomic position during childhood and during adulthood

BMJ 1996; 313 doi: (Published 07 December 1996) Cite this as: BMJ 1996;313:1434
  1. D Blane, senior lecturer in medical sociologya,
  2. C L Hart, research assistantb,
  3. G Davey Smith, professor of clinical epidemiologyc,
  4. C R Gillis, director4,
  5. D J Hole, principal epidemiologistd,
  6. V M Hawthorne, emeritus professor5
  1. a Academic Department of Psychiatry, Charing Cross and Westminster Medical School, London W6 8RP
  2. b Department of Public Health, University of Glasgow, Glasgow G12 8RZ
  3. c Department of Social Medicine, University of Bristol, Bristol BS8 2PR
  4. d West of Scotland Cancer Surveillance Unit, Ruchill Hospital, Glasgow G20 9NB
  5. e Department of Epidemiology, University of Michigan, Michigan 48109
  1. Correspondence to: Dr Blane.
  • Accepted 16 October 1996


Objective: To investigate strength of associations between risk factors for cardiovascular disease and socioeconomic position during childhood and adulthood.

Design: Cross sectional analysis of status of cardiovascular risk factors and past and present social circumstances.

Subjects: 5645 male participants in the west of Scotland collaborative study, a workplace screening study.

Main outcome measures: Strength of association between each risk factor for cardiovascular disease (diastolic blood pressure, serum cholesterol concentration, level of recreational physical exercise, cigarette smoking, body mass index, and FEV1 score (forced expiratory volume in one second as percentage of expected value) and social class during childhood (based on father's main occupation) and adulthood (based on own occupation at time of screening).

Results: All the measured risk factors were significantly associated with both father's and own social class (P<0.05), apart from exercise and smoking (not significantly associated with father's social class) and body mass index (not significantly associated with own social class). For all risk factors except body mass index, the regression coefficient of own social class was larger than the regression coefficient of father's social class. The difference between the coefficients was significant for serum cholesterol concentration, cigarette smoking, body mass index, and FEV1 score (all P<0.001).

Conclusions: Subjects' status for behavioural risk factors (exercise and smoking) was associated primarily with current socioeconomic circumstances, while status for physiological risk factors (serum cholesterol, blood pressure, body mass index, and FEV1) was associated to varying extents with both past and present socioeconomic circumstances.

Key messages

  • We examined associations between six such risk factors and working men's social conditions during childhood and adulthood; the risk factors varied in the strength of their associations with childhood and adult conditions

  • Behavioural risk factors (cigarette smoking and recreational physical exercise) were more strongly associated with adult circumstances

  • Physiological risk factors (diastolic blood pres- sure, serum cholesterol concentration, FEV1 score, and body mass index) were associated to varying degrees with both childhood and adult circum- stances except for body mass index, which seemed unrelated to the latter

  • The authors conclude that, as most of the main risk factors varied with adult social conditions, it is likely that they can be modified at this time


  • Funding Our study was supported by a grant from the NHS Management Executive, Cardiovascular Disease, and Stroke Research and Development Initiative.

  • Conflict of interest None.

  • Accepted 16 October 1996
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