Læknablaðið - 15.12.1998, Page 9

LÆKNABLAÐIÐ 1998; 84
913
Samband menntunar og dánartíðni með
sérstöku tilliti til kransæðasjúkdóma
Hóprannsókn Hjartaverndar
Maríanna Garöarsdóttir11, Þóröur Haröarson1’21, Guömundur Þorgeirsson1'2’, Helgi Sigvaldason3’,
Nikulás Sigfússon31
Garðarsdóttir M, Harðarson Þ, Þorgeirsson G,
Sigvaldason H, Sigfússon N
The relationship of education and mortality with
special concern to coronary heart disease mor-
tality. The Reykjavík Studv
Læknablaðið 1998; 84; 913-20
Objective: Coronary heart disease is a leading cause
of death in the Western world and coronary heart
disease mortality has been connected with socio-eco-
nomic status. Formerly, coronary heart disease mor-
tality was higher among those with higher educatio-
nal achievement, but recent research has shown this
relationship to have been reversed. To assess this in
Iceland, a prospective study of the relationship bet-
ween education and coronary heart disease mortality
as well as mortality due to all causes was performed.
Material and methods: This study was a part of the
Reykjavík Study. The participants (18,912) were di-
vided into four groups according to education. The
relationship between education and mortality was
assessed with the Cox proportional hazards model,
using the group of lowest educational status as a
reference. Corrections were made for age and year of
examination along with risk factors (cholesterol, tri-
glycerides, systolic blood pressure, glucose tolerance
and smoking).
Results: A statistically significant negative relation-
ship between education and coronary heart disease
mortality was found for men and women (p<0.02 and
p<0.01 respectively). Mortality risk of the highest
Frá "læknadeild HÍ, Zllyflækningadeild Landspítalans,
3lRannsóknarstöð Hjartaverndar. Fyrirspurnir, bréfaskipti;
Maríanna Garðarsdóttir, Garðastræti 44, 101 Reykjavík.
Netfang: marianna@menandmice.com
Lykilorö: kransæöasjúkdómar, dánartíðni, menntun,
þjóðfélagsstaða.
educational group was 66% of the lowest group for
men and 23% for women. The relationship was pre-
sent after adjustment for risk factors, but significant
for men only (p<0.03 and p>0.10 respectively).
Conclusions: Education has a significant indepen-
dent protective effect against coronary heart disease
mortality in men. The same relationship is probably
present among women, but fewer deaths had occur-
red. Educational status was a strong predictor of
mortality and known risk factors only explained a
small part of the mortality difference between vari-
ous educational groups. Higher education was also
associated with lowered mortality due to all causes.
Keywords: coronary heart disease, mortality, education,
socio-economic status.
Ágrip
Tilgangur: Hjarta- og æðasjúkdómar eru al-
gengasta dánarorsök á Vesturlöndum og hefur
dánartíðnin tengst þjóðfélagsstöðu. Aður voru
hjarta- og æðasjúkdómar tíðari hjá þeim sem
höfðu meiri menntun, en nýlegar rannsóknir
hafa sýnt hið gagnstæða. Til að kanna hvernig
þessu væri háttað hérlendis var gerð fram-
skyggn rannsókn á sambandi menntunar og
heildardánartíðni og dánartíðni af völdum
kransæðasjúkdóma.
Efniviður og aðferðir: Rannsókn þessi var
hluti hóprannsóknar Hjartaverndar. Alls tóku
þátt 18.912 einstaklingar og var þeim skipt í
fjóra hópa eftir menntun. Samband menntunar
og dánartíðni var metið með áhættulíkani Cox
og var hópur 4, lægsta menntunarstaða, lagður
til grundvallar. Leiðrétt var fyrir aldri og skoð-
unarári ásamt áhættuþáttum (kólesteróli og þrí-
glýseríðum í sermi, slagþrýstingi, sykurþoli og
reykingum).
Niðurstöður: I ljós kom tölfræðilega mark-