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Socioeconomic Status and the Incidence of Atrial Fibrillation in Whites and Blacks: The Atherosclerosis Risk in Communities (ARIC) Study
BACKGROUND: No previous studies have examined the interplay among socioeconomic status, sex, and race with the risk of atrial fibrillation (AF). METHODS AND RESULTS: We prospectively followed 14 352 persons (25% black, 75% white, 55% women, mean age 54 years) who were free of AF and participating in...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Blackwell Publishing Ltd
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310413/ https://www.ncbi.nlm.nih.gov/pubmed/25142059 http://dx.doi.org/10.1161/JAHA.114.001159 |
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author | Misialek, Jeffrey R. Rose, Kathryn M. Everson‐Rose, Susan A. Soliman, Elsayed Z. Clark, Cari J. Lopez, Faye L. Alonso, Alvaro |
author_facet | Misialek, Jeffrey R. Rose, Kathryn M. Everson‐Rose, Susan A. Soliman, Elsayed Z. Clark, Cari J. Lopez, Faye L. Alonso, Alvaro |
author_sort | Misialek, Jeffrey R. |
collection | PubMed |
description | BACKGROUND: No previous studies have examined the interplay among socioeconomic status, sex, and race with the risk of atrial fibrillation (AF). METHODS AND RESULTS: We prospectively followed 14 352 persons (25% black, 75% white, 55% women, mean age 54 years) who were free of AF and participating in the Atherosclerosis Risk in Communities (ARIC) study. Socioeconomic status was assessed at baseline (1987–1989) through educational level and total family income. Incident AF through 2009 was ascertained from electrocardiograms, hospitalizations, and death certificates. Cox regression was used to estimate hazard ratios and 95% CIs of AF for education and family income. Interactions were tested between socioeconomic status and age, race, or sex. Over a median follow‐up of 20.6 years, 1794 AF cases occurred. Lower family income was associated with higher AF risk (hazard ratio 1.45, 95% CI 1.27 to 1.67 in those with income less than $25 000 per year compared with those with $50 000 or more per year). The association between education and AF risk varied by sex (P=0.01), with the lowest education group associated with higher AF risk in women (hazard ratio 1.88, 95% CI 1.55 to 2.28) but not in men (hazard ratio 1.15, 95% CI 0.97 to 1.36) compared with the highest education group. Adjustment for cardiovascular risk factors attenuated the associations. There were no interactions with race or age. Blacks had lower AF risk than whites in all income and education groups. CONCLUSIONS: Lower family income was associated with a higher AF risk overall, whereas the impact of education on AF risk was present only in women. Differences in socioeconomic status do not explain the lower risk of AF in blacks compared with whites. |
format | Online Article Text |
id | pubmed-4310413 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Blackwell Publishing Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-43104132015-02-10 Socioeconomic Status and the Incidence of Atrial Fibrillation in Whites and Blacks: The Atherosclerosis Risk in Communities (ARIC) Study Misialek, Jeffrey R. Rose, Kathryn M. Everson‐Rose, Susan A. Soliman, Elsayed Z. Clark, Cari J. Lopez, Faye L. Alonso, Alvaro J Am Heart Assoc Original Research BACKGROUND: No previous studies have examined the interplay among socioeconomic status, sex, and race with the risk of atrial fibrillation (AF). METHODS AND RESULTS: We prospectively followed 14 352 persons (25% black, 75% white, 55% women, mean age 54 years) who were free of AF and participating in the Atherosclerosis Risk in Communities (ARIC) study. Socioeconomic status was assessed at baseline (1987–1989) through educational level and total family income. Incident AF through 2009 was ascertained from electrocardiograms, hospitalizations, and death certificates. Cox regression was used to estimate hazard ratios and 95% CIs of AF for education and family income. Interactions were tested between socioeconomic status and age, race, or sex. Over a median follow‐up of 20.6 years, 1794 AF cases occurred. Lower family income was associated with higher AF risk (hazard ratio 1.45, 95% CI 1.27 to 1.67 in those with income less than $25 000 per year compared with those with $50 000 or more per year). The association between education and AF risk varied by sex (P=0.01), with the lowest education group associated with higher AF risk in women (hazard ratio 1.88, 95% CI 1.55 to 2.28) but not in men (hazard ratio 1.15, 95% CI 0.97 to 1.36) compared with the highest education group. Adjustment for cardiovascular risk factors attenuated the associations. There were no interactions with race or age. Blacks had lower AF risk than whites in all income and education groups. CONCLUSIONS: Lower family income was associated with a higher AF risk overall, whereas the impact of education on AF risk was present only in women. Differences in socioeconomic status do not explain the lower risk of AF in blacks compared with whites. Blackwell Publishing Ltd 2014-08-20 /pmc/articles/PMC4310413/ /pubmed/25142059 http://dx.doi.org/10.1161/JAHA.114.001159 Text en © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/3.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Research Misialek, Jeffrey R. Rose, Kathryn M. Everson‐Rose, Susan A. Soliman, Elsayed Z. Clark, Cari J. Lopez, Faye L. Alonso, Alvaro Socioeconomic Status and the Incidence of Atrial Fibrillation in Whites and Blacks: The Atherosclerosis Risk in Communities (ARIC) Study |
title | Socioeconomic Status and the Incidence of Atrial Fibrillation in Whites and Blacks: The Atherosclerosis Risk in Communities (ARIC) Study |
title_full | Socioeconomic Status and the Incidence of Atrial Fibrillation in Whites and Blacks: The Atherosclerosis Risk in Communities (ARIC) Study |
title_fullStr | Socioeconomic Status and the Incidence of Atrial Fibrillation in Whites and Blacks: The Atherosclerosis Risk in Communities (ARIC) Study |
title_full_unstemmed | Socioeconomic Status and the Incidence of Atrial Fibrillation in Whites and Blacks: The Atherosclerosis Risk in Communities (ARIC) Study |
title_short | Socioeconomic Status and the Incidence of Atrial Fibrillation in Whites and Blacks: The Atherosclerosis Risk in Communities (ARIC) Study |
title_sort | socioeconomic status and the incidence of atrial fibrillation in whites and blacks: the atherosclerosis risk in communities (aric) study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310413/ https://www.ncbi.nlm.nih.gov/pubmed/25142059 http://dx.doi.org/10.1161/JAHA.114.001159 |
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