American Journal of Epidemiology, Vol 152, Issue 7 617-627, Copyright © 2000 by Oxford University Press
R Din-Dzietham, D Liao, A Diez-Roux, FJ Nieto, C Paton, G Howard, A Brown, M Carnethon and HA Tyroler
Education is strongly inversely associated with common carotid artery
intima-media thickness in the Atherosclerosis Risk in Communities (ARIC)
Study. The authors extended the ARIC study of preclinical atherosclerosis
by evaluating the cross-sectional association of education with common
carotid artery elasticity. This study included 10,091 Black and White men
and women aged 45-64 years who were free of clinical coronary heart disease
and stroke/transient ischemic attack. Arterial elasticity was assessed by
pulsatile arterial diameter change (PADC), derived from phase-locked
echo-tracking. The smaller the PADC, the stiffer the artery. Education was
categorized into grade school, high school without graduation, high school
with graduation, vocational school, some college, and graduate/professional
school. PADC was directly associated with educational attainment. The mean
PADCs, adjusted for age, height, diastolic diameter, systolic blood
pressure, pulse pressure (linear and squared), ethnicity, gender, and
smoking status, in successively higher education strata were 402 (standard
error (SE) 5), 403 (SE 4), 407 (SE 3), 413 (SE 4), 416 (SE 2), and 417 (SE
4) microm (p = 0.007). To the authors' knowledge, this is the first time
such an association has been reported. If arterial dilation impairment
precedes arterial wall thickening in the atherosclerotic process, as recent
studies on endothelial dysfunction suggest, these results indicate that low
socioeconomic status may be associated with early arterial pathophysiologic
changes-an effect that appears to be mediated by established cardiovascular
disease risk factors.
ARTICLES
Association of educational achievement with pulsatile arterial diameter change of the common carotid artery: the Atherosclerosis Risk in Communities (ARIC) Study, 1987-1992
Division of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill 27514, USA.
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