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August 2002, Vol 92, No. 8 | American Journal of Public Health 1295-1298
© 2002 American Public Health Association


RESEARCH AND PRACTICE

Life-Course Socioeconomic and Behavioral Influences on Cardiovascular Disease Mortality: The Collaborative Study

George Davey Smith, MD, MSc, DSc, FFPHM and Carole Hart, MA, BSc

George Davey Smith is with the Department of Social Medicine, University of Bristol, England. Carole Hart is with the Department of Public Health, University of Glasgow, Scotland.

Correspondence: Requests for reprints should be sent to George Davey Smith, MD, MSc, DSc, FFPHM, Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Rd, Bristol BS8 2PR, United Kingdom (e-mail: zetkin{at}bristol.ac.uk).

Objectives. This study sought to demonstrate life-course influences on cardiovascular disease (CVD).

Methods. Data were derived from a prospective observational study in which the main outcome measure was death resulting from CVD.

Results. Combining 4 socioeconomic and behavioral risk indicators into a measure of life-course exposure produced 5 groups whose relative risks of CVD mortality ranged from 1.00 (the group with the most favorable life-course exposures) to 4.55 (the group with the least favorable life-course exposures). If the entire study population had had the CVD mortality risk of the subsample with the most favorable risk factor profile, approximately two thirds of cardiovascular deaths would not have occurred.

Conclusions. CVD risk is influenced in a cumulative fashion by socioeconomic and behavioral factors acting throughout the life course.




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