Higher education is associated with reduced risk of heart failure among patients with acute myocardial infarction: A nationwide analysis using data from the CVDNOR project

Sulo, Gerhard; Nygård, Ottar; Vollset, Stein Emil; Igland, Jannicke; Ebbing, Marta; Sulo, Enxhela; Egeland, Grace M.; Tell, Grethe S.

doi:10.1177/2047487316655910

Cited by 8 publications

(3 citation statements)

References 36 publications

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“…21,22 For the management of ACS in an environment of incurring significant out-of-pocket expenditure, these factors may have influenced the use of some treatments among patients with less formal education. 4,12,23 The findings from the current study are consistent with previous Chinese reports. 24,25 Whether China's recent progress towards universal health insurance has positively influenced such observations is not clear.…”

Section: Discussionsupporting

confidence: 92%

Associations Between Education Level and In-hospital Treatment and Outcomes Among Acute Coronary Syndrome in China

Peng

et al. 2021

The American Journal of the Medical Sciences

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Section: Discussionsupporting

confidence: 92%

Associations Between Education Level and In-hospital Treatment and Outcomes Among Acute Coronary Syndrome in China

Peng

et al. 2021

The American Journal of the Medical Sciences

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“…However, the possible mediators and mechanisms for these causal associations were not examined by our MR analysis. The reasons might be that the gradients in education or income influenced the existing gradients of dietary behavior, unhealthy lifestyle factors, environmental factors, and cognitive ability to disease, ultimately resulting in disparate stone outcomes [ 45 , 46 ]. Furthermore, our MR outcomes showed no significant associations of smoking, alcohol consumption, glucocorticoid use, physical activity, sedentary leisure hours, and diet with the risk of kidney stones.…”

Section: Discussionmentioning

confidence: 99%

Causal effects of modifiable risk factors on kidney stones: a bidirectional mendelian randomization study

Wang

Liu

et al. 2023

BMC Med Genomics

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Background Increasing epidemiological studies demonstrated that modifiable risk factors affected the risk of kidney stones. We aimed to systemically assess these causal associations using a bidirectional Mendelian randomization study. Methods We obtained instrumental variables related to each exposure at the genome-wide significant threshold (P < 5 × 10–8). Summary level data for outcomes from the FinnGen consortium and UK Biobank were utilized in the discovery and replication stage. The Inverse-variance weighted (IVW) method was used as the primary analysis, with additional sensitivity analyses and fix-effect meta-analysis to verify the robustness of IVW results. Results Among 46 risk factors, five were significantly associated with nephrolithiasis risk in the FinnGen consortium, UK Biobank, and meta-analyses collectively. The odds ratios (ORs) (95% confidence intervals [95%CIs]) of kidney stones were 1.21 (1.13, 1.29) per standard deviation (SD) increase in serum calcium, 1.55 (1.01, 2.36) per SD increase in serum 25(OH)D, 1.14 (1.00, 1.29) per SD increase in total triglycerides, 2.38 (1.34, 4.22) per SD increase in fasting insulin, and 0.28 (0.23, 0.35) per unit increase in log OR of urine pH. In addition, genetically predicted serum phosphorus, urinary sodium, tea consumption, and income affected the risk of kidney stones (false discovery rate [FDR] P < 0.05) based on the outcome data from the FinnGen consortium, and the significant associations of education and waist-to-hip ratio with nephrolithiasis risks were found after FDR correction (FDR P < 0.05) based on the outcome data from UK Biobank. Conclusions Our findings comprehensively provide modifiable risk factors for the prevention of nephrolithiasis. Genome-wide association studies with larger sample sizes are needed to verify these causal associations in the future further.

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“…Moreover, consistent evidence suggests that higher educational attainment is correlated with a decreased lifetime risk of cardiovascular diseases ( 23 ). Regarding specific cardiovascular conditions, research demonstrated an inverse relationship between educational attainment and the likelihood of heart failure in patients with coronary heart disease ( 24 ). This highlights the potential benefit of implementing preventive measures for individuals with lower education levels to address survival disparities.…”

Section: Discussionmentioning

confidence: 99%

Education and cardiovascular diseases: a Mendelian randomization study

Liu,

Lin,

Fan

et al. 2024

Front. Cardiovasc. Med.

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BackgroundObservational studies have indicated a potential association between education and cardiovascular diseases (CVDs). However, uncertainties regarding the causal relationship persist. Therefore, this study aimed to investigate whether higher levels of education causally reduce the risks of CVDs.MethodsEmploying a two-sample Mendelian randomization (MR) design, our study examined the relationship between education and ten different CVDs. Utilizing data from the IEU Open GWAS database, relevant single nucleotide polymorphisms (SNPs) were identified through stringent screening criteria. Causality was assessed using the inverse-variance weighted (IVW), ME-Egger regression, and weighted median methods. Sensitivity analyses, including heterogeneity and pleiotropy tests, were conducted to ensure the robustness of our findings.ResultsOur study identified a genetic predisposition associated with an additional 3.6 years of education, which significantly reduced the risk of various CVDs. Specifically, this genetic factor was found to lower the risk of type 2 diabetes by 46.5%, coronary heart disease by 37.5%, ischemic stroke by 35.4%, cardiac-related mortality by 28.6%, heart failure by 28.2%, transient ischemic attack by 24%, atrial fibrillation by 15.2%, peripheral artery disease by 0.3%, and hypertension by 0.3%. However, no significant evidence revealed a causal relationship between education and pulmonary embolism.ConclusionOur study provides robust evidence supporting the role of higher educational attainment in reducing the incidence of various cardiovascular diseases, including type 2 diabetes, coronary heart disease, ischemic stroke, cardiac-related mortality, heart failure, transient ischemic attack, atrial fibrillation, peripheral artery disease, and hypertension. However, the impact of education on pulmonary embolism remains inconclusive.

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Higher education is associated with reduced risk of heart failure among patients with acute myocardial infarction: A nationwide analysis using data from the CVDNOR project

Abstract: We observed an inverse association between educational level and risk of HF. More efforts in preventing this severe complication of AMI among less educated patients may help to reduce the socioeconomic gap in survival following coronary events.

Cited by 8 publications

References 36 publications

Associations Between Education Level and In-hospital Treatment and Outcomes Among Acute Coronary Syndrome in China

Associations Between Education Level and In-hospital Treatment and Outcomes Among Acute Coronary Syndrome in China

Causal effects of modifiable risk factors on kidney stones: a bidirectional mendelian randomization study

Education and cardiovascular diseases: a Mendelian randomization study

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