Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromsø Study
Introduction: Cardiovascular disease (CVD) is a leading cause of death and disability and living in areas with low socio-economic status (SES) is associated with increased risk of CVD. Lifestyle factors such as smoking, physical inactivity, an unhealthy diet and harmful alcohol use are main risk fac...
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ftunivtroemsoe:oai:munin.uit.no:10037/27640 2023-05-15T18:34:21+02:00 Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromsø Study Tiwari, Sweta Cerin, Ester Wilsgaard, Tom Løvsletten, Ola Njølstad, Inger Grimsgaard, Sameline Hopstock, Laila Arnesdatter Schirmer, Henrik Rosengren, Annika Kristoffersen, Kathrine Løchen, Maja-Lisa 2022-09-24 https://hdl.handle.net/10037/27640 https://doi.org/10.1016/j.ssmph.2022.101241 eng eng Elsevier SSM - Population Health Norges forskningsråd: 289440 Tiwari, Cerin, Wilsgaard, Løvsletten, Njølstad, Grimsgaard, Hopstock, Schirmer, Rosengren, Kristoffersen, Løchen. Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromsø Study. SSM - Population Health. 2022;19 FRIDAID 2062223 doi:10.1016/j.ssmph.2022.101241 2352-8273 https://hdl.handle.net/10037/27640 Attribution 4.0 International (CC BY 4.0) openAccess Copyright 2022 The Author(s) https://creativecommons.org/licenses/by/4.0 CC-BY Journal article Tidsskriftartikkel Peer reviewed publishedVersion 2022 ftunivtroemsoe https://doi.org/10.1016/j.ssmph.2022.101241 2022-12-08T00:02:36Z Introduction: Cardiovascular disease (CVD) is a leading cause of death and disability and living in areas with low socio-economic status (SES) is associated with increased risk of CVD. Lifestyle factors such as smoking, physical inactivity, an unhealthy diet and harmful alcohol use are main risk factors that contribute to other modifiable risk factors, such as hypertension, raised blood cholesterol, obesity, and diabetes. The potential impact of arealevel socio-economic status (ASES) on metabolic CVD risk factors via lifestyle behaviors independent of individual SES has not been investigated previously. Aims: To estimate associations of ASES with CVD risk factors and the mediating role of lifestyle behaviors independent of individual-level SES. Methods: In this cross-sectional study, we included 19,415 participants (52% women) from the seventh survey of the Tromsø Study (2015–2016) (Tromsø7). The exposure variable ASES was created by aggregating individuallevel SES variables (education, income, housing ownership) at the geographical subdivision level. Individuallevel SES data and geographical subdivision of Tromsø municipality (36 areas) were obtained from Statistics Norway. Variables from questionnaires and clinical examinations obtained from Tromsø7 were used as mediators (smoking, snuff, alcohol, and physical activity), while the outcome variables were body mass index (BMI), total/ high-density lipoprotein (HDL) cholesterol ratio, waist circumference, hypertension, diabetes. Mediation and mediated moderation analysis were performed with age as a moderator, stratified by sex. Results: ASES was significantly associated with all outcome variables. CVD risk factor level declined with an increase in ASES. These associations were mediated by differences in smoking habits, alcohol use and physical activity. The associations of ASES with total/HDL cholesterol ratio and waist circumference (women) were moderated by age, and the moderating effects were mediated by smoking and physical activity in both sexes. The ... Article in Journal/Newspaper Tromsø University of Tromsø: Munin Open Research Archive Norway Tromsø SSM - Population Health 19 101241 |
institution |
Open Polar |
collection |
University of Tromsø: Munin Open Research Archive |
op_collection_id |
ftunivtroemsoe |
language |
English |
description |
Introduction: Cardiovascular disease (CVD) is a leading cause of death and disability and living in areas with low socio-economic status (SES) is associated with increased risk of CVD. Lifestyle factors such as smoking, physical inactivity, an unhealthy diet and harmful alcohol use are main risk factors that contribute to other modifiable risk factors, such as hypertension, raised blood cholesterol, obesity, and diabetes. The potential impact of arealevel socio-economic status (ASES) on metabolic CVD risk factors via lifestyle behaviors independent of individual SES has not been investigated previously. Aims: To estimate associations of ASES with CVD risk factors and the mediating role of lifestyle behaviors independent of individual-level SES. Methods: In this cross-sectional study, we included 19,415 participants (52% women) from the seventh survey of the Tromsø Study (2015–2016) (Tromsø7). The exposure variable ASES was created by aggregating individuallevel SES variables (education, income, housing ownership) at the geographical subdivision level. Individuallevel SES data and geographical subdivision of Tromsø municipality (36 areas) were obtained from Statistics Norway. Variables from questionnaires and clinical examinations obtained from Tromsø7 were used as mediators (smoking, snuff, alcohol, and physical activity), while the outcome variables were body mass index (BMI), total/ high-density lipoprotein (HDL) cholesterol ratio, waist circumference, hypertension, diabetes. Mediation and mediated moderation analysis were performed with age as a moderator, stratified by sex. Results: ASES was significantly associated with all outcome variables. CVD risk factor level declined with an increase in ASES. These associations were mediated by differences in smoking habits, alcohol use and physical activity. The associations of ASES with total/HDL cholesterol ratio and waist circumference (women) were moderated by age, and the moderating effects were mediated by smoking and physical activity in both sexes. The ... |
format |
Article in Journal/Newspaper |
author |
Tiwari, Sweta Cerin, Ester Wilsgaard, Tom Løvsletten, Ola Njølstad, Inger Grimsgaard, Sameline Hopstock, Laila Arnesdatter Schirmer, Henrik Rosengren, Annika Kristoffersen, Kathrine Løchen, Maja-Lisa |
spellingShingle |
Tiwari, Sweta Cerin, Ester Wilsgaard, Tom Løvsletten, Ola Njølstad, Inger Grimsgaard, Sameline Hopstock, Laila Arnesdatter Schirmer, Henrik Rosengren, Annika Kristoffersen, Kathrine Løchen, Maja-Lisa Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromsø Study |
author_facet |
Tiwari, Sweta Cerin, Ester Wilsgaard, Tom Løvsletten, Ola Njølstad, Inger Grimsgaard, Sameline Hopstock, Laila Arnesdatter Schirmer, Henrik Rosengren, Annika Kristoffersen, Kathrine Løchen, Maja-Lisa |
author_sort |
Tiwari, Sweta |
title |
Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromsø Study |
title_short |
Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromsø Study |
title_full |
Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromsø Study |
title_fullStr |
Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromsø Study |
title_full_unstemmed |
Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromsø Study |
title_sort |
lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. the tromsø study |
publisher |
Elsevier |
publishDate |
2022 |
url |
https://hdl.handle.net/10037/27640 https://doi.org/10.1016/j.ssmph.2022.101241 |
geographic |
Norway Tromsø |
geographic_facet |
Norway Tromsø |
genre |
Tromsø |
genre_facet |
Tromsø |
op_relation |
SSM - Population Health Norges forskningsråd: 289440 Tiwari, Cerin, Wilsgaard, Løvsletten, Njølstad, Grimsgaard, Hopstock, Schirmer, Rosengren, Kristoffersen, Løchen. Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromsø Study. SSM - Population Health. 2022;19 FRIDAID 2062223 doi:10.1016/j.ssmph.2022.101241 2352-8273 https://hdl.handle.net/10037/27640 |
op_rights |
Attribution 4.0 International (CC BY 4.0) openAccess Copyright 2022 The Author(s) https://creativecommons.org/licenses/by/4.0 |
op_rightsnorm |
CC-BY |
op_doi |
https://doi.org/10.1016/j.ssmph.2022.101241 |
container_title |
SSM - Population Health |
container_volume |
19 |
container_start_page |
101241 |
_version_ |
1766219050661183488 |