Key result
Low childhood parental income is linked to ~43% higher odds of midlife coronary atherosclerosis.
Why the study?
Socioeconomic status is a major risk factor for coronary heart disease, but the life-course mechanisms and causal pathways remain poorly understood.
Does low childhood socioeconomic status increase the risk of moderate-severe coronary atherosclerosis in midlife?
Cohort (n=15,640)
Does low childhood socioeconomic status increase the risk of moderate-severe coronary atherosclerosis in midlife?
Odds Ratio: 1.43 (95% CI 1.2–1.71)
p-value: p=<0.001
Low childhood socioeconomic status is a social determinant of long-term cardiovascular health associated with midlife coronary atherosclerosis, not fully explained by established adult risk factors.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Our findings show that socio-economic circumstances early in life have an impact on cardiovascular health several decades later. We believe the link reflects a lifelong accumulation of risk factors that we do not fully capture with data from adulthood. Being overweight during childhood may be one such factor.”
“We believe the link reflects a lifelong accumulation of risk factors that we do not fully capture with data from adulthood. Being overweight during childhood may be one such factor. There is also research suggesting that low socio-economic status early in life may affect biological processes linked to stress and inflammation. However, the significance of these mechanisms needs to be investigated further.”
Low childhood SES marks higher midlife atherosclerosis odds independent of adult factors; hypothesis-generating for early interventions, should not yet change practice.
Background Socioeconomic status (SES) is a major risk factor for coronary heart disease, but the life‐course mechanisms and causal pathways remain poorly understood. Therefore, we investigated whether low childhood SES was associated with midlife coronary atherosclerosis and if any association could be explained by established risk factors in adulthood. Methods This observational cohort study included 15 640 participants, aged 50 to 64 years, from the population‐based SCAPIS (Swedish Cardiopulmonary Bioimage Study) who underwent coronary computed tomography angiography. Coronary atherosclerosis was assessed by segment involvement score and coronary artery calcification score. Childhood SES was defined by parental disposable income at participant age 10 to 12 years retrieved from national registers. Associations between moderate–severe coronary atherosclerosis (segment involvement score ≥4 or coronary artery calcification >100) and childhood SES were estimated using multivariable logistic regression adjusting for adult lifestyle habits, adult SES, and traditional cardiovascular risk factors. Results Participants in the lowest versus highest parental income quintile were more likely to have moderate–severe coronary atherosclerosis (segment involvement score ≥4; odds ratio [OR], 1.43 [95% CI, 1.20–1.71], P <0.001). The association persisted after adjustment for adult lifestyle habits (OR, 1.42 [95% CI, 1.17–1.73], P <0.001), adult SES (OR, 1.31 [95% CI, 1.09–1.57], P =0.004), traditional cardiovascular risk factors (OR, 1.28 [95% CI, 1.06–1.53], P =0.008), and full adjustment (OR, 1.31 [95% CI, 1.07–1.61], P =0.010). Similar associations were observed for coronary artery calcification >100. Conclusions Low childhood SES was associated with moderate–severe coronary atherosclerosis in midlife only partially explained by established risk factors in adulthood. Our findings suggest that childhood SES is a social determinant of long‐term cardiovascular health that cannot be fully explained by established adult risk factors.
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Herlitz et al. (2026) conducted a cohort in Coronary atherosclerosis (n=15,640). Low childhood socioeconomic status (lowest parental income quintile) vs. Highest parental income quintile was evaluated on Moderate-severe coronary atherosclerosis (segment involvement score ≥4) (OR 1.43, 95% CI 1.20-1.71, p=<0.001). Participants in the lowest versus highest childhood parental income quintile had significantly higher odds of moderate-severe coronary atherosclerosis in midlife (OR 1.43; 95% CI 1.20-1.71; P<0.001).
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