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Lifestyle factors explain almost half of protective effect of education on heart disease risk

Lifestyle factors may partially explain the increased rates of heart disease among those with lower educational attainment, a study has found. 

BMI, blood pressure and smoking behaviour may mediate just under half of the protective effect of education on heart disease, the researchers concluded.

The study, published in the BMJ, was led by epidemiologists and looked at just over 200,000 British participants. The researchers used genetic variants that are linked to educational attainment, BMI, blood pressure and smoking behaviour to determine how much of the effect of education was related to modifiable risk factors.

They found that for every 3.6 years spent in education, there was an associated 37% reduction in risk of coronary heart disease.

They also found that BMI, blood pressure and smoking behaviour accounted for 18%, 21% and 34% of the effect of education on coronary heart disease. When combined, all three risk factors explained 42% of the effect of education.

Researchers said that knowing which factors mediate the protective effect of education on heart disease can help policy makers to target public health interventions better.

They said in the paper: ‘The findings of this study have notable implications for policymakers as they identify potential strategies for reducing education inequalities in health. Furthermore, they also produce quantitative estimates of this, allowing specific consideration of the potential impact to public health.’

Co-lead author and PhD student in population health sciences at the University of Bristol, Alice Carter, commented: ‘Our work shows that there may be opportunities to intervene, after education is completed, to reduce the potential risk of heart disease. By lowering BMI, blood pressure or rates of smoking in individuals who left school at an earlier age, we could reduce their overall risk of heart disease.

‘However, it is important to note this work looks at the effect of education on a population level risk of heart disease – and leaving school earlier does not necessarily mean an individual will go on to develop heart disease.’

It follows news that progress has slowed in tackling premature deaths frm heart attacks and strokes


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