TY - JOUR
T1 - Are the educational differences in incidence of cardiovascular disease explained by underlying familial factors?
T2 - A twin study
AU - Madsen, Mia
AU - Andersen, Per Kragh
AU - Gerster, Mette
AU - Andersen, Anne-Marie Nybo
AU - Christensen, Kaare
AU - Osler, Merete
N1 - Copyright © 2014 Elsevier Ltd. All rights reserved.
PY - 2014/10
Y1 - 2014/10
N2 - To isolate the effect of education from the influence of potential underlying factors, we investigated the association of education with the risk of cardiovascular disease (CVD) and ischemic heart disease (IHD) using twin data to adjust for familial factors shared within twins, including genetic make-up and childhood environment. The study was based on data from the Danish Twin Registry linked to administrative and heath registers in Statistics Denmark. A total of 11,968 monozygotic and 20,464 dizygotic same sexed twins were followed from 1980 to 2009, including more than 8000 events of CVD. Unpaired and intra-pair analyses were compared. In the unpaired analyses, an inverse educational gradient in CVD- and IHD risk was observed. This association was not replicated in the intra-pair analyses that control for shared familial factors exploiting that twins share their intrauterine- and childhood environment and are matched partly or fully on genetic setup. The attenuation of association of education with CVD and IHD in the intra-pair analyses suggests that shared familial factors account for a substantial part of the observed association of education with CVD and IHD in Denmark.
AB - To isolate the effect of education from the influence of potential underlying factors, we investigated the association of education with the risk of cardiovascular disease (CVD) and ischemic heart disease (IHD) using twin data to adjust for familial factors shared within twins, including genetic make-up and childhood environment. The study was based on data from the Danish Twin Registry linked to administrative and heath registers in Statistics Denmark. A total of 11,968 monozygotic and 20,464 dizygotic same sexed twins were followed from 1980 to 2009, including more than 8000 events of CVD. Unpaired and intra-pair analyses were compared. In the unpaired analyses, an inverse educational gradient in CVD- and IHD risk was observed. This association was not replicated in the intra-pair analyses that control for shared familial factors exploiting that twins share their intrauterine- and childhood environment and are matched partly or fully on genetic setup. The attenuation of association of education with CVD and IHD in the intra-pair analyses suggests that shared familial factors account for a substantial part of the observed association of education with CVD and IHD in Denmark.
U2 - 10.1016/j.socscimed.2014.04.016
DO - 10.1016/j.socscimed.2014.04.016
M3 - Comment/debate
C2 - 24768271
VL - 118
SP - 182
EP - 190
JO - Social Science & Medicine
JF - Social Science & Medicine
SN - 0277-9536
ER -