Abstract
OBJECTIVE: Low socioeconomic status (SES) is associated with cardiovascular risk factors and increased coronary artery disease (CAD) risk. We tested whether SES is an effect modifier of the association between classical cardiovascular risk factors and CAD using SES-stratified Mendelian Randomization in European-ancestry participants from UK Biobank. STUDY DESIGN AND SETTING: We calculated weighted genetic risk scores (GRS) for the risk factors body mass index (BMI), systolic blood pressure, LDL cholesterol, and triglycerides. Participants were stratified by Townsend deprivation index (TDI) score. Logistic regression models were used to investigate associations between GRSs and CAD occurrence. Additionally, stratification based on GRS-adjusted TDI residuals was conducted to correct for possible collider-stratification bias. RESULTS: In a total sample size of N=446,485, with 52,946 cases, the risk for CAD per SD increase in genetically-influenced BMI was highest in the group with the lowest 25% SES (OR: 1.126, 95% CI: 1.106-1.145; OR: 1.081, 95% CI: 1.059-1.103 in high SES), remaining similar after controlling for possible collider-stratification bias. The effects of genetically-influenced systolic blood pressure, LDL cholesterol, and triglyceride on CAD were similar between SES groups. CONCLUSION: CAD risk attributable to increased BMI is not homogenous and could be modified by SES. This emphasizes the need of tailor-made approaches for BMI-associated CAD risk reduction.
6 Authors
- Leon G Martens
- Daan van Hamersveld
- Saskia le Cessie
- Ko Willems van Dijk
- Diana van Heemst
- Raymond Noordam
1 Application
Application ID | Title |
56340 | Prevention of myocardial infarction and primary atherogenic cardiovascular disease from a sex-specific life course perspective |