Education, 15-year risk factor progression, and coronary artery calcium in young adulthood and early middle age: the Coronary Artery Risk Development in Young Adults study

JAMA : the Journal of the American Medical Association
Lijing L YanPhilip Greenland

Abstract

The inverse association between education and cardiovascular disease is well established, but little is known about the relationship between education and subclinical disease, which is free from medical access and treatment-related influences, or about possible mediating pathways for these relationships. To examine the association of education with coronary artery calcium (CAC), an indicator of subclinical atherosclerosis, and cardiovascular risk factors, and their changes as potential mediators. A population-based, prospective, observational study (Coronary Artery Risk Development in Young Adults [CARDIA]) of 2913 eligible participants (44.9% black; 53.9% women) recruited from 4 metropolitan areas (Birmingham, Ala; Chicago, Ill; Minneapolis, Minn; and Oakland, Calif) in both the baseline (1985-1986, ages 18-30 years) and year 15 examinations (2000-2001, ages 33-45 years). Education (year 15) was classified into less than high school (n = 128), high school graduate (n = 498), some college (n = 902), college graduate (n = 764), and more than college (n = 621). Presence of CAC, measured twice by computed tomography (mean total Agatston score >0) at year 15. Overall CAC prevalence in this sample was 9.3%. After adjusting for age, ...Continue Reading

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