Socioeconomic status and aortic atherosclerosis in Dutch elderly people. The Rotterdam study

Abstract

An inverse association has been reported between socioeconomic status (SES) and cardiovascular morbidity and mortality. Studies on subclinical manifestations of atherosclerotic disease are limited and have not been carried out among elderly persons. The authors investigated the relation between SES and aortic atherosclerosis among elderly people. As part of the Rotterdam Study, data on SES and atherosclerosis were collected for 4,451 persons aged 55-94 years. Atherosclerosis was estimated by radiographic assessment of calcified deposits in the abdominal aorta. Aortic atherosclerosis was more common among women in the lower educational and occupational strata. The lowest educational group and the lowest occupational group had increased risks of aortic atherosclerosis compared with the highest groups (odds ratios were 1.3 (95% confidence interval (CI) 1.0-1.6) and 1.3 (95% CI 1.0-1.8), respectively). The odds ratios for severe atherosclerosis among women in the lowest socioeconomic stratum compared with those in the highest stratum were 1.6 (95% CI 1.0-2.7) for education, 2.8 (95% CI 1.1- 7.5) for occupation, and 1.7 (95% CI 0.9-3.3) for income. After exclusion of persons with a history of cardiovascular disease, the same trends still emerged. No relations were observed among men. These findings show that SES is related to aortic atherosclerosis in women. This suggests that SES affects the incidence of cardiovascular disease before its clinical manifestation.