Abstract P078: Exploring Social Inequalities in Ischemic Stroke Incidence in Europe. The MORGAM Project Cohort Component
Aims. To explore the magnitude of educational-class inequalities in ischemic stroke incidence in European populations, and to assess to what extent they can be explained by major risk factors. Methods. The MORGAM study comprised 45 cohorts from Nordic Countries (Finland, Denmark, Sweden), UK (Northe...
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Ovid Technologies (Wolters Kluwer Health)
2015
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Online Access: | http://dx.doi.org/10.1161/circ.131.suppl_1.p078 http://journals.lww.com/00003017-201503101-00216 |
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crovidcr:10.1161/circ.131.suppl_1.p078 2023-05-15T17:45:09+02:00 Abstract P078: Exploring Social Inequalities in Ischemic Stroke Incidence in Europe. The MORGAM Project Cohort Component Ferrario, Marco M Veronesi, Giovanni Chambless, Lloyd E Kuulasmaa, Kari Soderberg, Stefan Salomaa, Veikko Pajak, Andrzej Amouyel, Philippe Arveiler, Dominique Drygas, Wojciech Ferrieres, Jean Hart, Nigel Jorgensen, Torben Malyutina, Sofia Peters, Annette Tamosiunas, Abdonas Tunstall-Pedoe, Hugh Cesana, Giancarlo 2015 http://dx.doi.org/10.1161/circ.131.suppl_1.p078 http://journals.lww.com/00003017-201503101-00216 en eng Ovid Technologies (Wolters Kluwer Health) Circulation volume 131, issue suppl_1 ISSN 0009-7322 1524-4539 Physiology (medical) Cardiology and Cardiovascular Medicine journal-article 2015 crovidcr https://doi.org/10.1161/circ.131.suppl_1.p078 2022-05-29T06:56:41Z Aims. To explore the magnitude of educational-class inequalities in ischemic stroke incidence in European populations, and to assess to what extent they can be explained by major risk factors. Methods. The MORGAM study comprised 45 cohorts from Nordic Countries (Finland, Denmark, Sweden), UK (Northern Ireland, Scotland), Central EU (France, Germany, Northern Italy) and East EU (Lithuania, Poland) and Russia. Only cohorts with both fatal and non-fatal ischemic strokes during follow-up (median 12 years, IQR 10-19 years) were included. Baseline data were collected adhering to MONICA-like procedures. Stroke subtype was attributed based on hospital records and death codes. We derived 3 educational classes from population-, sex- and birth year-specific tertiles of years of schooling. We used Poisson regression models to estimate the age-adjusted difference in event rates between the bottom and the top educational classes distribution (Slope Index of Inequality, SII) and the proportion of events to be redistributed to achieve equality in event rates among educational classes (Relative Concentration Index, RCI). We estimated the pooled age- and risk factors-adjusted hazard ratios for bottom to top education (Relative Index of Inequality, RII) from sex-specific Cox models with a dummy variable for each population . We also tested the hypothesis of homogeneity of inequalities across populations by adding population*education interaction terms. The contribution of risk factors to RII was measured by: (lnRII[RFadj]- lnRII[AGEadj]) / lnRII[AGEadj] Results. The cohorts included 66,052 CVD-free subjects aged 35-64 years (37,181 men) at baseline. In men, the age-adjusted inequalities in ischemic stroke rates (SIIs) were 125 events per 100,000 person-years in the Nordic Countries, 156 in the UK and 178 in Central EU; the RCIs were 6%, 13% and 21%, respectively. In women, an inverse gradient (higher rates among more educated subjects) was present in Northern Sweden; in the remaining populations, the SII (RCI) ranged between 4 ... Article in Journal/Newspaper Northern Sweden Ovid (via Crossref) Circulation 131 suppl_1 |
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Open Polar |
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Ovid (via Crossref) |
op_collection_id |
crovidcr |
language |
English |
topic |
Physiology (medical) Cardiology and Cardiovascular Medicine |
spellingShingle |
Physiology (medical) Cardiology and Cardiovascular Medicine Ferrario, Marco M Veronesi, Giovanni Chambless, Lloyd E Kuulasmaa, Kari Soderberg, Stefan Salomaa, Veikko Pajak, Andrzej Amouyel, Philippe Arveiler, Dominique Drygas, Wojciech Ferrieres, Jean Hart, Nigel Jorgensen, Torben Malyutina, Sofia Peters, Annette Tamosiunas, Abdonas Tunstall-Pedoe, Hugh Cesana, Giancarlo Abstract P078: Exploring Social Inequalities in Ischemic Stroke Incidence in Europe. The MORGAM Project Cohort Component |
topic_facet |
Physiology (medical) Cardiology and Cardiovascular Medicine |
description |
Aims. To explore the magnitude of educational-class inequalities in ischemic stroke incidence in European populations, and to assess to what extent they can be explained by major risk factors. Methods. The MORGAM study comprised 45 cohorts from Nordic Countries (Finland, Denmark, Sweden), UK (Northern Ireland, Scotland), Central EU (France, Germany, Northern Italy) and East EU (Lithuania, Poland) and Russia. Only cohorts with both fatal and non-fatal ischemic strokes during follow-up (median 12 years, IQR 10-19 years) were included. Baseline data were collected adhering to MONICA-like procedures. Stroke subtype was attributed based on hospital records and death codes. We derived 3 educational classes from population-, sex- and birth year-specific tertiles of years of schooling. We used Poisson regression models to estimate the age-adjusted difference in event rates between the bottom and the top educational classes distribution (Slope Index of Inequality, SII) and the proportion of events to be redistributed to achieve equality in event rates among educational classes (Relative Concentration Index, RCI). We estimated the pooled age- and risk factors-adjusted hazard ratios for bottom to top education (Relative Index of Inequality, RII) from sex-specific Cox models with a dummy variable for each population . We also tested the hypothesis of homogeneity of inequalities across populations by adding population*education interaction terms. The contribution of risk factors to RII was measured by: (lnRII[RFadj]- lnRII[AGEadj]) / lnRII[AGEadj] Results. The cohorts included 66,052 CVD-free subjects aged 35-64 years (37,181 men) at baseline. In men, the age-adjusted inequalities in ischemic stroke rates (SIIs) were 125 events per 100,000 person-years in the Nordic Countries, 156 in the UK and 178 in Central EU; the RCIs were 6%, 13% and 21%, respectively. In women, an inverse gradient (higher rates among more educated subjects) was present in Northern Sweden; in the remaining populations, the SII (RCI) ranged between 4 ... |
format |
Article in Journal/Newspaper |
author |
Ferrario, Marco M Veronesi, Giovanni Chambless, Lloyd E Kuulasmaa, Kari Soderberg, Stefan Salomaa, Veikko Pajak, Andrzej Amouyel, Philippe Arveiler, Dominique Drygas, Wojciech Ferrieres, Jean Hart, Nigel Jorgensen, Torben Malyutina, Sofia Peters, Annette Tamosiunas, Abdonas Tunstall-Pedoe, Hugh Cesana, Giancarlo |
author_facet |
Ferrario, Marco M Veronesi, Giovanni Chambless, Lloyd E Kuulasmaa, Kari Soderberg, Stefan Salomaa, Veikko Pajak, Andrzej Amouyel, Philippe Arveiler, Dominique Drygas, Wojciech Ferrieres, Jean Hart, Nigel Jorgensen, Torben Malyutina, Sofia Peters, Annette Tamosiunas, Abdonas Tunstall-Pedoe, Hugh Cesana, Giancarlo |
author_sort |
Ferrario, Marco M |
title |
Abstract P078: Exploring Social Inequalities in Ischemic Stroke Incidence in Europe. The MORGAM Project Cohort Component |
title_short |
Abstract P078: Exploring Social Inequalities in Ischemic Stroke Incidence in Europe. The MORGAM Project Cohort Component |
title_full |
Abstract P078: Exploring Social Inequalities in Ischemic Stroke Incidence in Europe. The MORGAM Project Cohort Component |
title_fullStr |
Abstract P078: Exploring Social Inequalities in Ischemic Stroke Incidence in Europe. The MORGAM Project Cohort Component |
title_full_unstemmed |
Abstract P078: Exploring Social Inequalities in Ischemic Stroke Incidence in Europe. The MORGAM Project Cohort Component |
title_sort |
abstract p078: exploring social inequalities in ischemic stroke incidence in europe. the morgam project cohort component |
publisher |
Ovid Technologies (Wolters Kluwer Health) |
publishDate |
2015 |
url |
http://dx.doi.org/10.1161/circ.131.suppl_1.p078 http://journals.lww.com/00003017-201503101-00216 |
genre |
Northern Sweden |
genre_facet |
Northern Sweden |
op_source |
Circulation volume 131, issue suppl_1 ISSN 0009-7322 1524-4539 |
op_doi |
https://doi.org/10.1161/circ.131.suppl_1.p078 |
container_title |
Circulation |
container_volume |
131 |
container_issue |
suppl_1 |
_version_ |
1766147918266368000 |