“…Health and risk of premature death are determined by socio-economic factors acting throughout life (Smith et al, 1997). A lower socio-economic status has an adverse impact on the prognosis of patients with coronary heart disease (Gundle et al, 1980;Kinchla and Weiss, 1985;Williams and Littmann, 1996). According to Smith et al (1997) it has recently been demonstrated that it is important to consider the cumulative effect of socio-environmental exposures over a life time and that the risk of cardiovascular death at an early stage is particularly sensitive to socio-economic influences acting in early life.…”