Should Years of Schooling Be Used to Guide Treatment of Coronary Risk Factors?

Article Figures & Data

Table 1.

Distribution of Coronary Heart Disease Risk Factors by Educational Level in Sample

	Prevalence of Risk Factor by Educational Level
Risk Factor	<12 Years %	12 Years %	>12 Years %
Note: Numbers in each row refer to the percentage of persons in each educational category. Numbers may not total to 100 because of rounding.
Age, years
65–74	64	18	18
55–64	48	33	19
45–54	38	38	23
35–44	27	42	31
25–34	19	41	40
Sex
Male	35	41	24
Female	36	32	32
Systolic blood pressure (mm Hg)
>160	56	28	17
140–169	44	33	23
130–139	35	36	29
120–129	30	41	30
<120	27	39	34
Diabetes
Yes	64	23	12
No	35	37	28
Cholesterol level (mg/dL)
>280	44	34	22
240–279	41	35	23
200–239	35	38	28
<200	30	37	33
Smoker
Yes	37	38	25
No	34	36	30

Table 2.

Risk Factor Prevalence and Adjusted 10-Year Risk of Coronary Heart Disease Mortality

			Adjusted 10-Year CHD Mortality Risk
Risk Factor	Risk Factor Prevalence (SE)	Relative Risk	95% CI	Marginal Risk	95% CI
CHD = coronary heart disease; SE = standard error; CI = confidence interval.
Age, years
65–74	12.1 (0.4)	6.3	4.5–7.4	7.3	5.6–9.0
54–64	17.9 (0.6)	3.7	2.4–4.7	3.0	2.2–3.8
45–54	22.1 (0.5)	2.9	1.7–3.7	2.0	1.2–2.8
35–44	21.1 (0.7)	2.6	1.3–3.9	1.5	0.6–2.5
25–34 (referent)	26.9 (0.7)	1.0	1.0–1.0	0.4	0.0–0.7
Education (years)
<12	35.5 (0.9)	1.5	1.2–1.8	3.4	2.9–4.0
12	36.5 (0.9)	1.2	0.8–1.6	2.3	1.5–3.1
>12 (referent)	28.0 (0.9)	1.0	1.0–1.0	1.8	1.1 – 2.5
Sex
Male	47.5 (0.7)	1.5	1.3–1.6	3.9	3.2–4.6
Female (referent)	52.5 (0.7)	1.0	1.0–1.0	1.8	1.3–2.3
Systolic blood pressure (mm Hg)
>160	11.3 (0.5)	2.9	2.0–4.1	4.8	3.4–6.2
140–159	19.3 (0.6)	1.9	1.3v2.7	3.2	2.3–4.0
130–139	17.5 (0.6)	1.6	1.0–2.4	2.5	1.5–3.5
120–129	20.5 (0.5)	1.2	0.6–2.0	1.7	0.8 – 2.5
<120 (referent)	31.3 (0.9)	1.0	1.0–1.0	1.3	0.7–2.0
Diabetes mellitus	2.0 (0.3)	1.8	0.8–3.8	4.6	1.4–7.8
No diabetes mellitus (referent)	98.0 (0.3)	1.0	1.0–1.0	2.7	2.3–3.2
Cholesterol (mg/dL)
>280	10.2 (0.5)	1.6	0.9 – 2.7	3.7	2.3–5.0
240–279	20.5 (0.5)	1.3	0.9 – 1.8	2.9	2.2–3.7
200–239	34.4 (0.6)	1.1	0.8 – 1.5	2.7	1.9–3.6
<200 (referent)	34.9 (0.9)	1.0	1.0 – 1.0	2.2	1.4–3.1
Smoker	41.6 (0.8)	1.4	1.1 – 1.6	3.9	2.9–4.8
Non–smoker (referent)	58.4 (0.8)	1.0	1.0 – 1.0	2.2	1.8–2.7

Table 3.

Adjusted 10-Year Risk of Coronary Heart Disease Mortality by Cholesterol Level, Stratified by Education

	<12 Years Education		≥12 Years Education
Cholesterol Level (mg/dL)	Mortality Risk (%)	95% CI	Mortality Risk (%)	95% CI
CHD = coronary heart disease; CI = confidence interval.
≥280	7.6	4.5–10.7	2.2	0.6–3.8
240–279	6.5	4.7 – 8.2	1.4	0.7–2.0
200–239	5.7	3.6 – 7.8	1.6	0.8–2.3
<200	2.4	0.6 – 3.8	1.3	0.7–2.0

The Article in Brief

Patients who have not finished high school have a higher risk of dying of coronary heart disease than those with more schooling. The risk is as strong as other risks such as high cholesterol and smoking. This finding can help medical professionals identify and provide early treatment for people who may be at risk of heart disease.