Attained Educational Level and Incident Atherothrombotic Events in Low- and Middle-Income Compared With High-Income Countries

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dc.contributor.authorGoyal, Abhinav
dc.contributor.authorBhatt, Deepak L.
dc.contributor.authorSteg, P. Gabriel
dc.contributor.authorGersh, Bernard J.
dc.contributor.authorAlberts, Mark J.
dc.contributor.authorOhman, E. Magnus
dc.contributor.authorCorbalan, Ramon
dc.contributor.authorEagle, Kim A.
dc.contributor.authorGaxiola, Efrain
dc.contributor.authorGao, Runlin
dc.contributor.authorGoto, Shinya
dc.contributor.authorD'Agostino, Ralph B.
dc.contributor.authorCaliff, Robert M.
dc.contributor.authorSmith, Sidney C., Jr.
dc.contributor.authorWilson, Peter W. F.
dc.contributor.authorREACH Registry Investigators
dc.date.accessioned2024-01-10T13:46:13Z
dc.date.available2024-01-10T13:46:13Z
dc.date.issued2010
dc.description.abstractBackground-Studies report a protective effect of higher attained educational level (AEL) on cardiovascular outcomes. However, most of these studies have been conducted in high-income countries (HICs) and lack representation from low and middle-income countries (LMICs), which bear >80% of the global burden of cardiovascular disease.
dc.description.abstractMethods and Results-The Reduction of Atherothrombosis for Continued Health (REACH) Registry is a prospective study of 67 888 subjects with either established atherothrombotic (coronary, cerebrovascular, and/or peripheral arterial) disease or multiple atherothrombotic risk factors enrolled from 5587 physician practices in 44 countries. At baseline, AEL (0 to 8 years, 9 to 12 years, trade or technical school, and university) was self-reported for 61 332 subjects. Outcomes included the baseline prevalence of atherothrombotic risk factors and the rate of incident cardiovascular events (cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke) through 23 months across AEL groups, stratified by sex and world region (LMICs or HICs). Educational attainment was inversely associated with age and diabetes mellitus and directly associated with hypercholesterolemia in all subjects. However, for other risk factors such as obesity, smoking, hypertension, and baseline burden of vascular disease, AEL was protective (inversely associated) in HICs but not protective in LMICs. The protective effect of greater AEL on incident cardiovascular events was strongest in men from HICs (P<0.0001), more modest in women from HICs (P=0.0026) and in men from LMICs (P=0.082), and essentially absent in women from LMICs (P=0.32).
dc.description.abstractConclusion-In contrast to HICs, higher AEL may not be protective against cardiovascular events in LMICs, particularly in women. (Circulation. 2010;122:1167-1175.)
dc.description.funderSanofi-aventis (Paris, France)
dc.description.funderBristol-Myers Squibb (Princeton, NJ)
dc.description.funderWaksman Foundation (Tokyo, Japan)
dc.fechaingreso.objetodigital2024-05-20
dc.format.extent9 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1161/CIRCULATIONAHA.109.919274
dc.identifier.eissn1524-4539
dc.identifier.issn0009-7322
dc.identifier.pubmedidMEDLINE:20823388
dc.identifier.urihttps://doi.org/10.1161/CIRCULATIONAHA.109.919274
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/79135
dc.identifier.wosidWOS:000282042100006
dc.information.autorucMedicina;Corbalan R;S/I;98700
dc.issue.numero12
dc.language.isoen
dc.nota.accesocontenido parcial
dc.pagina.final1175
dc.pagina.inicio1167
dc.publisherLIPPINCOTT WILLIAMS & WILKINS
dc.revistaCIRCULATION
dc.rightsacceso restringido
dc.subjectcardiovascular diseases
dc.subjectepidemiology
dc.subjectregistries
dc.subjectrisk factors
dc.subjectsmoking
dc.subjectRISK-FACTORS
dc.subjectMYOCARDIAL-INFARCTION
dc.subjectSOCIOECONOMIC-STATUS
dc.subjectWOMEN
dc.subjectINEQUALITIES
dc.subjectOUTPATIENTS
dc.subjectMORTALITY
dc.subjectOBESITY
dc.subjectDISEASE
dc.subjectIMPACT
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleAttained Educational Level and Incident Atherothrombotic Events in Low- and Middle-Income Compared With High-Income Countries
dc.typeartículo
dc.volumen122
sipa.codpersvinculados98700
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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