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Socioeconomic position and incidence of acute myocardial infarction: a meta-analysis
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
2011 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 65, no 4, 301-309 p.Article in journal (Refereed) Published
Abstract [en]

Background

A negative socioeconomic gradient is established for coronary heart disease (CHD) mortality and survival, while socioeconomic patterning of disease incidence is less well investigated. To study socioeconomic inequalities in the incidence of acute myocardial infarction (AMI), the major component of CHD, a meta-analysis was undertaken to summarise existing evidence on the issue.

Methods

A systematic search was performed in PubMed and EMBASE databases for observational studies on AMI incidence and socioeconomic position (SEP), published in English to April 2009. A random-effects model was used to pool the risks estimates from the individual studies.

Results

Among 1181 references, 70 studies fulfilled the inclusion criteria. An overall increased risk of AMI among the lowest SEP was found for all three indicators: income (pooled RR 1.71, 95% CI 1.43 to 2.05), occupation (pooled RR 1.35, 95% CI 1.19 to 1.53) and education (pooled RR 1.34, 95% CI 1.22 to 1.47). The strongest associations were seen in high-income countries such as USA/Canada and Europe, while the results were inconsistent for middle and low-income regions.

Conclusion

AMI incidence is associated with low SEP. The nature of social stratification at the level of economic development of a country could be involved in the differences of risk of AMI between social groups.

Place, publisher, year, edition, pages
2011. Vol. 65, no 4, 301-309 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-142215DOI: 10.1136/jech.2009.104075ISI: 000287962800004PubMedID: 20841371OAI: oai:DiVA.org:uu-142215DiVA: diva2:387102
Available from: 2011-01-13 Created: 2011-01-13 Last updated: 2017-12-11Bibliographically approved

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Hallqvist, Johan

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