Socioeconomic status, cardiovascular risk factors, and subclinical atherosclerosis in young adults: The Cardiovascular Risk in Young Finns Study

Objective: The goal of this study was to investigate the extent to which socioeconomic status (SES) in young adults is associated with cardiovascular risk factor levels and carotid intima-media thickness (IMT) and their changes over a 6-year follow-up period.

Methods and Results: The study population included 1813 subjects participating in the 21- and 27-year follow-ups of the Cardiovascular Risk in Young Finns Study (baseline age 24-39 years in 2001). At baseline, SES (indexed with education) was inversely associated with body mass index (P = 0.0002), waist circumference (P<0.0001), glucose (P = 0.01), and insulin (P = 0.0009) concentrations; inversely associated with alcohol consumption (P = 0.02) and cigarette smoking (P < 0.0001); and directly associated with high-density lipoprotein cholesterol levels (P = 0.05) and physical activity (P=0.006). Higher SES was associated with a smaller 6-year increase in body mass index (P = 0.001). Education level and IMT were not associated (P=0.58) at baseline, but an inverse association was observed at follow-up among men (P = 0.004). This became nonsignificant after adjustment with conventional risk factors (P = 0.11). In all subjects, higher education was associated with a smaller increase in IMT during the follow-up (P = 0.002), and this association remained after adjustments for conventional risk factors (P = 0.04).

Conclusion: This study shows that high education in young adults is associated with favorable cardiovascular risk factor profile and 6-year change of risk factors. Most importantly, the progression of carotid atherosclerosis was slower among individuals with higher educational level.