Fibrinogen: a possible link between social class and coronary heart disease.

Abstract

I'ree M. A microassav for active and total renin concentration in htomani plasma based tiO antibodv trapping. Chitn (/hinm lAt-t 1980;101:5-15 12 Dusterdieck G(, McEllwee Mortality from coronary heart disease in civil servants in the lowest grade of employment has been found to be about three times that of men in the highest grade of employment. As part of an investigation ofthis finding several haemostatic variables were measured in a sample of 29 men in lower grades of employment and 45 men in higher grades. There was a significant difference in plasma fibrinogen concentrations between men in lower grades of employment and those in higher grades (mean 3 39 g/l v 2-95 g/l, respectively; p<O0Ol) but not in other haemostatic variables. Multiple regression analyses showed significant independent associations of fibrinogen concentration with smoking (p<OO5) and grade of employment (p<O0O5). The size of the observed difference between the grades of employment was similar to that between those dying of coronary heart disease or surviving during longitudinal study; it may therefore be an important part

Protective and Damaging Effects of Stress Mediators

“…Plasma fibrinogen concentrations, which predict an increased risk of death from coronary heart disease, are elevated among men in the lower British civil-service grades. 56 In less stable societies, conflict and social instability have been found to accelerate pathophysiologic processes and increase morbidity and mortality. For example, cardiovascular disease is a major contributor to the increase of almost 40 percent in the death rate among Russian men during the social collapse that followed the fall of Communism.…”

“…54 Chronic stress (feelings of fatigue, lack of energy, irritability, and demoralization) and hostility are linked to increased reactivity of the fibrinogen system and of platelets, both of which increase the risk of myocardial infarction. 55,56 Quantifying allostatic load, a major challenge, has been attempted with the use of measures of metabolic and cardiovascular pathophysiology. In a recent analysis, 57 data from the MacArthur Studies of Successful Aging were used to assess eight measures of increased activity of allostatic systems between 1988 and 1991.…”

Plasma fibrinogen — an independent cardiovascular risk factor

“…Fibrinogen is related to social class, which has in part been attributed to different levels of emotional stress [79]. The association between fibrinogen or other clotting factors and stress has recently been emphasized [go].…”

Social connectedness is associated with fibrinogen level in a human social network

“…Indeed, elevated fibrinogen levels predict future ischaemic heart disease and stroke [15,16], and, as early as 1985, fibrinogen was identified as a possible link between disadvantaged social position and risk of cardiac death [17]. Fibrinogen has been linked to low occupational status, education and sense of control [18], as well as to perceptions of being socially undermined [19], and to self-reported loneliness and isolation [20].…”