Systematic review of the influence of childhood socioeconomic circumstances on risk for cardiovascular disease in adulthood

被引:442
作者
Galobardes, B
Smith, GD
Lynch, JW
机构
[1] Univ Bristol, Dept Social Med, Bristol BS8 2PR, Avon, England
[2] McGill Univ, Dept Epidemiol Biostat & Occupat Hlth, Montreal, PQ, Canada
基金
英国医学研究理事会;
关键词
socioeconomic position; childhood; cardiovascular disease; systematic review; life course;
D O I
10.1016/j.annepidem.2005.06.053
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
PURPOSE: Adverse socioeconomic circumstances in childhood may confer a greater risk for adult cardiovascular disease (CVD). The purpose of this review is to systematically evaluate evidence for an association between socioeconomic circumstances during childhood and specific CVD subtypes, independent of adult socioeconomic conditions. METHODS: We systematically retrieved individual-level studies of morbidity and mortality from CVD and specific CVD subtypes linked to early life influences, including coronary heart disease (CHD), ischemic and hemorrhagic stroke, peripheral vascular disease, markers of atherosclerosis (carotid intima-media thickness and stenosis), and rheumatic heart disease. Indicators of socioeconomic position in childhood varied, although most studies relied on father's occupation. RESULTS: We located 40 studies (24 prospective, 11 case-control, and 5 cross-sectional) reported in 50 publications. Thirty-one studies (19 prospective, 7 case-control, and all 5 cross-sectional) found a robust inverse association between childhood circumstances and CVD risk, although findings sometimes varied among specific outcomes, socioeconomic measures, and sex. Case-control studies reported mixed results. The association was stronger for stroke and, in particular, hemorrhagic stroke, than for CHD. Childhood socioeconomic conditions remained important predictors of CVD, even in younger cohorts. CONCLUSION: Childhood and adulthood socioeconomic circumstances are important determinants of CVD risk. The specific contribution of childhood and adulthood characteristics varies across different CVD subtypes. Disease-specific mechanisms are likely to explain the childhood origins of these adult health inequalities.
引用
收藏
页码:91 / 104
页数:14
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