The association between educational status and risk factors related to cardiovascular disease in healthy individuals: The ATTICA study

Purpose The object of this work was to study the associations between education status and several cardiovascular risk factors in 2271 randomly selected male and female adults. Methods The formal education level was used as proxy for socio-economic status; the distribution of the risk factors and the prevalence of risk conditions were analyzed by the different levels of education—“low”, “medium”, and “high.” The association between education level and the investigated measurements was tested by the application of multiple regression analysis. Results Two hundred and twenty (19.8%) males and 292 (25.3%) females were classified as “low”, 471 (42.4%) males and 476 (41.3%) females as “medium”, and 421 (37.8%) males and 386 (33.4%) females as “high” educated. Compared with those with “low” education, individuals who reported “high” education had 8% lower systolic (p<0.001) and 4% lower diastolic (p<0.001) blood pressure levels, 6% lower blood glucose levels (p<0.001), 7% lower serum total cholesterol (p<0.001), 6% higher HDL-cholesterol (p<0.001), 22% lower lipoprotein-a levels (p<0.001), 11% lower apoliprotein-B levels (p<0.001), 15% lower triglycerides (p<0.001), 45% lower hs-CRP (p<0.001), 8% lower fibrinogen levels (p<0.01), and 7% lower white blood cell count (p<0.001). The associations regarding inflammation markers remained statistically significant even after adjustment for several potential confounders. Conclusions Our findings suggest that in primary prevention it is important to focus our attention, especially, on people with low education, since they seem to be rather unprotected against the prevalence of several cardiovascular risk factors.