Social determinants of cardiac disease biomarkers: investigating a Swedish male cohort at ages 50 and 70

BACKGROUND: Social status is associated with cardiovascular disease (CVD) prevalence and incidence. AIMS: to investigate relationships between socioeconomic position (SEP) and common CVD biomarkers including adiponectin not previously investigated in a Swedish-population sample, and to assess if these associations changed with age. DESIGN: Population-based longitudinal cohort study of men born 1920-24 with clinical measurements, blood samples, questionnaire data, and register-based information on SEP and cause of death. METHODS: A total of 2322 men attended an investigation at age 50 of which 1221 attended a reinvestigation at age 70. Association between SEP and CVD biomarkers [cholesterol, low-density lipoprotein/high-density lipoprotein (LDL/HDL), apolipoprotein (Apo) ApoB/ApoA1, and adiponectin] were analysed by linear regression (adjusted for age, body mass index, and physical activity). SEP was measured as occupational class and educational level. CVD mortality over 36 years of follow-up was analysed by Cox regression. RESULTS: At age 50, we found a significant inverse association of education with cholesterol level, LDL/HDL ratio and ApoB/ApoA1 ratio. Cholesterol was also associated with occupational class, statistically significant after adjustment for all covariates. At age 70, no significant associations were found between either measurement of SEP and any of the biomarkers studied. Highest educated men had decreased risk for CVD mortality during follow-up. CONCLUSIONS: Associations of SEP with cholesterol levels and LDL/HDL ratio that exist at age 50 are no longer apparent in the same group of men at age 70. We found no significant association between SEP and adiponectin levels at age 70.