Does IQ predict cardiovascular disease mortality as strongly as established risk factors? Comparison of effect estimates using the West of Scotland Twenty-07 cohort study

Objective To compare the strength of the association between intelligence quotient (IQ) and cardiovascular disease (CVD) mortality with the predictive power for established risk factors. Design Population-based cohort study of 1145 men and women with IQ test scores, a range of established risk factors, and 20-year mortality surveillance. Results When CVD mortality was the outcome of interest, the relative index of inequality (sex-adjusted hazard ratio, 95% confidence interval) for the most disadvantaged relative to the advantaged persons was (in descending order of magnitude for the top five risk factors): 5.58 (2.89, 10.8) for cigarette smoking; 3.76 (2.14, 6.61) for IQ; 3.20 (1.85, 5.54) for income; 2.61 (1.49, 4.57) for systolic blood pressure and 2.06 (1.07, 3.99) for physical activity. Mutual adjustment led to some attenuation of these relationships. Similar observations were made in the analyses featuring all deaths where, again, IQ was the second most powerful predictor of mortality risk. Conclusion In this cohort, lower intelligence scores were associated with increased rates of CVD and total mortality at a level of magnitude greater than most established risk factors. Eur J Cardiovasc Prev Rehabil 17:24-27 (C) 2010 The European Society of Cardiology