Association of childhood and adult socioeconomic indicators with cardiovascular risk factors and its modification by age: the CARLA Study 2002-2006
Background The influence of socioeconomic status (SES) on cardiovascular diseases and risk factors is widely known, although the role of different SES indicators is not fully understood. The aim of this study was to investigate the role of different SES indicators for cardiovascular disease risk fac...
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| Published in: | BMC public health Vol. 11; no. 1; p. 289 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
London
BioMed Central
10.05.2011
BioMed Central Ltd BMC |
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| ISSN: | 1471-2458, 1471-2458 |
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| Abstract | Background
The influence of socioeconomic status (SES) on cardiovascular diseases and risk factors is widely known, although the role of different SES indicators is not fully understood. The aim of this study was to investigate the role of different SES indicators for cardiovascular disease risk factors in a middle and old aged East German population.
Methods
Cross-sectional data of an East German population-based cohort study (1779 men and women aged 45 to 83) were used to assess the association of childhood and adulthood SES indicators (childhood SES, education, occupational position, income) with cardiovascular risk factors. Adjusted means and odds ratios of risk factors by SES indicators with 95% confidence intervals (CI) were calculated by linear and logistic regression models, stratified by sex. The interaction effect of education and age on cardiovascular risk factors was tested by including an interaction term.
Results
In age-adjusted models, education, occupational position, and income were statistically significantly associated with abdominal obesity in men, and with smoking in both sexes. Men with low education had a more than threefold risk of being a smoker (OR 3.44, CI 1.58-7.51). Low childhood SES was associated with higher systolic blood pressure and abdominal obesity in women (OR 2.27, CI 1.18-4.38 for obesity); a non-significant but (in terms of effect size) relevant association of childhood SES with smoking was observed in men. In women, age was an effect modifier for education in the risk of obesity and smoking.
Conclusions
We found considerable differences in cardiovascular risk factors by education, occupational position, income, and partly by childhood social status, differing by sex. Some social inequalities levelled off in higher age. Longitudinal studies are needed to differentiate between age and birth cohort effects. |
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| AbstractList | The influence of socioeconomic status (SES) on cardiovascular diseases and risk factors is widely known, although the role of different SES indicators is not fully understood. The aim of this study was to investigate the role of different SES indicators for cardiovascular disease risk factors in a middle and old aged East German population.BACKGROUNDThe influence of socioeconomic status (SES) on cardiovascular diseases and risk factors is widely known, although the role of different SES indicators is not fully understood. The aim of this study was to investigate the role of different SES indicators for cardiovascular disease risk factors in a middle and old aged East German population.Cross-sectional data of an East German population-based cohort study (1779 men and women aged 45 to 83) were used to assess the association of childhood and adulthood SES indicators (childhood SES, education, occupational position, income) with cardiovascular risk factors. Adjusted means and odds ratios of risk factors by SES indicators with 95% confidence intervals (CI) were calculated by linear and logistic regression models, stratified by sex. The interaction effect of education and age on cardiovascular risk factors was tested by including an interaction term.METHODSCross-sectional data of an East German population-based cohort study (1779 men and women aged 45 to 83) were used to assess the association of childhood and adulthood SES indicators (childhood SES, education, occupational position, income) with cardiovascular risk factors. Adjusted means and odds ratios of risk factors by SES indicators with 95% confidence intervals (CI) were calculated by linear and logistic regression models, stratified by sex. The interaction effect of education and age on cardiovascular risk factors was tested by including an interaction term.In age-adjusted models, education, occupational position, and income were statistically significantly associated with abdominal obesity in men, and with smoking in both sexes. Men with low education had a more than threefold risk of being a smoker (OR 3.44, CI 1.58-7.51). Low childhood SES was associated with higher systolic blood pressure and abdominal obesity in women (OR 2.27, CI 1.18-4.38 for obesity); a non-significant but (in terms of effect size) relevant association of childhood SES with smoking was observed in men. In women, age was an effect modifier for education in the risk of obesity and smoking.RESULTSIn age-adjusted models, education, occupational position, and income were statistically significantly associated with abdominal obesity in men, and with smoking in both sexes. Men with low education had a more than threefold risk of being a smoker (OR 3.44, CI 1.58-7.51). Low childhood SES was associated with higher systolic blood pressure and abdominal obesity in women (OR 2.27, CI 1.18-4.38 for obesity); a non-significant but (in terms of effect size) relevant association of childhood SES with smoking was observed in men. In women, age was an effect modifier for education in the risk of obesity and smoking.We found considerable differences in cardiovascular risk factors by education, occupational position, income, and partly by childhood social status, differing by sex. Some social inequalities levelled off in higher age. Longitudinal studies are needed to differentiate between age and birth cohort effects.CONCLUSIONSWe found considerable differences in cardiovascular risk factors by education, occupational position, income, and partly by childhood social status, differing by sex. Some social inequalities levelled off in higher age. Longitudinal studies are needed to differentiate between age and birth cohort effects. Background The influence of socioeconomic status (SES) on cardiovascular diseases and risk factors is widely known, although the role of different SES indicators is not fully understood. The aim of this study was to investigate the role of different SES indicators for cardiovascular disease risk factors in a middle and old aged East German population. Methods Cross-sectional data of an East German population-based cohort study (1779 men and women aged 45 to 83) were used to assess the association of childhood and adulthood SES indicators (childhood SES, education, occupational position, income) with cardiovascular risk factors. Adjusted means and odds ratios of risk factors by SES indicators with 95% confidence intervals (CI) were calculated by linear and logistic regression models, stratified by sex. The interaction effect of education and age on cardiovascular risk factors was tested by including an interaction term. Results In age-adjusted models, education, occupational position, and income were statistically significantly associated with abdominal obesity in men, and with smoking in both sexes. Men with low education had a more than threefold risk of being a smoker (OR 3.44, CI 1.58-7.51). Low childhood SES was associated with higher systolic blood pressure and abdominal obesity in women (OR 2.27, CI 1.18-4.38 for obesity); a non-significant but (in terms of effect size) relevant association of childhood SES with smoking was observed in men. In women, age was an effect modifier for education in the risk of obesity and smoking. Conclusions We found considerable differences in cardiovascular risk factors by education, occupational position, income, and partly by childhood social status, differing by sex. Some social inequalities levelled off in higher age. Longitudinal studies are needed to differentiate between age and birth cohort effects. Background The influence of socioeconomic status (SES) on cardiovascular diseases and risk factors is widely known, although the role of different SES indicators is not fully understood. The aim of this study was to investigate the role of different SES indicators for cardiovascular disease risk factors in a middle and old aged East German population. Methods Cross-sectional data of an East German population-based cohort study (1779 men and women aged 45 to 83) were used to assess the association of childhood and adulthood SES indicators (childhood SES, education, occupational position, income) with cardiovascular risk factors. Adjusted means and odds ratios of risk factors by SES indicators with 95% confidence intervals (CI) were calculated by linear and logistic regression models, stratified by sex. The interaction effect of education and age on cardiovascular risk factors was tested by including an interaction term. Results In age-adjusted models, education, occupational position, and income were statistically significantly associated with abdominal obesity in men, and with smoking in both sexes. Men with low education had a more than threefold risk of being a smoker (OR 3.44, CI 1.58-7.51). Low childhood SES was associated with higher systolic blood pressure and abdominal obesity in women (OR 2.27, CI 1.18-4.38 for obesity); a non-significant but (in terms of effect size) relevant association of childhood SES with smoking was observed in men. In women, age was an effect modifier for education in the risk of obesity and smoking. Conclusions We found considerable differences in cardiovascular risk factors by education, occupational position, income, and partly by childhood social status, differing by sex. Some social inequalities levelled off in higher age. Longitudinal studies are needed to differentiate between age and birth cohort effects. BACKGROUND: The influence of socioeconomic status (SES) on cardiovascular diseases and risk factors is widely known, although the role of different SES indicators is not fully understood. The aim of this study was to investigate the role of different SES indicators for cardiovascular disease risk factors in a middle and old aged East German population. METHODS: Cross-sectional data of an East German population-based cohort study (1779 men and women aged 45 to 83) were used to assess the association of childhood and adulthood SES indicators (childhood SES, education, occupational position, income) with cardiovascular risk factors. Adjusted means and odds ratios of risk factors by SES indicators with 95% confidence intervals (CI) were calculated by linear and logistic regression models, stratified by sex. The interaction effect of education and age on cardiovascular risk factors was tested by including an interaction term. RESULTS: In age-adjusted models, education, occupational position, and income were statistically significantly associated with abdominal obesity in men, and with smoking in both sexes. Men with low education had a more than threefold risk of being a smoker (OR 3.44, CI 1.58-7.51). Low childhood SES was associated with higher systolic blood pressure and abdominal obesity in women (OR 2.27, CI 1.18-4.38 for obesity); a non-significant but (in terms of effect size) relevant association of childhood SES with smoking was observed in men. In women, age was an effect modifier for education in the risk of obesity and smoking. CONCLUSIONS: We found considerable differences in cardiovascular risk factors by education, occupational position, income, and partly by childhood social status, differing by sex. Some social inequalities levelled off in higher age. Longitudinal studies are needed to differentiate between age and birth cohort effects. Abstract Background The influence of socioeconomic status (SES) on cardiovascular diseases and risk factors is widely known, although the role of different SES indicators is not fully understood. The aim of this study was to investigate the role of different SES indicators for cardiovascular disease risk factors in a middle and old aged East German population. Methods Cross-sectional data of an East German population-based cohort study (1779 men and women aged 45 to 83) were used to assess the association of childhood and adulthood SES indicators (childhood SES, education, occupational position, income) with cardiovascular risk factors. Adjusted means and odds ratios of risk factors by SES indicators with 95% confidence intervals (CI) were calculated by linear and logistic regression models, stratified by sex. The interaction effect of education and age on cardiovascular risk factors was tested by including an interaction term. Results In age-adjusted models, education, occupational position, and income were statistically significantly associated with abdominal obesity in men, and with smoking in both sexes. Men with low education had a more than threefold risk of being a smoker (OR 3.44, CI 1.58-7.51). Low childhood SES was associated with higher systolic blood pressure and abdominal obesity in women (OR 2.27, CI 1.18-4.38 for obesity); a non-significant but (in terms of effect size) relevant association of childhood SES with smoking was observed in men. In women, age was an effect modifier for education in the risk of obesity and smoking. Conclusions We found considerable differences in cardiovascular risk factors by education, occupational position, income, and partly by childhood social status, differing by sex. Some social inequalities levelled off in higher age. Longitudinal studies are needed to differentiate between age and birth cohort effects. The influence of socioeconomic status (SES) on cardiovascular diseases and risk factors is widely known, although the role of different SES indicators is not fully understood. The aim of this study was to investigate the role of different SES indicators for cardiovascular disease risk factors in a middle and old aged East German population. Cross-sectional data of an East German population-based cohort study (1779 men and women aged 45 to 83) were used to assess the association of childhood and adulthood SES indicators (childhood SES, education, occupational position, income) with cardiovascular risk factors. Adjusted means and odds ratios of risk factors by SES indicators with 95% confidence intervals (CI) were calculated by linear and logistic regression models, stratified by sex. The interaction effect of education and age on cardiovascular risk factors was tested by including an interaction term. In age-adjusted models, education, occupational position, and income were statistically significantly associated with abdominal obesity in men, and with smoking in both sexes. Men with low education had a more than threefold risk of being a smoker (OR 3.44, CI 1.58-7.51). Low childhood SES was associated with higher systolic blood pressure and abdominal obesity in women (OR 2.27, CI 1.18-4.38 for obesity); a non-significant but (in terms of effect size) relevant association of childhood SES with smoking was observed in men. In women, age was an effect modifier for education in the risk of obesity and smoking. We found considerable differences in cardiovascular risk factors by education, occupational position, income, and partly by childhood social status, differing by sex. Some social inequalities levelled off in higher age. Longitudinal studies are needed to differentiate between age and birth cohort effects. The influence of socioeconomic status (SES) on cardiovascular diseases and risk factors is widely known, although the role of different SES indicators is not fully understood. The aim of this study was to investigate the role of different SES indicators for cardiovascular disease risk factors in a middle and old aged East German population. Cross-sectional data of an East German population-based cohort study (1779 men and women aged 45 to 83) were used to assess the association of childhood and adulthood SES indicators (childhood SES, education, occupational position, income) with cardiovascular risk factors. Adjusted means and odds ratios of risk factors by SES indicators with 95% confidence intervals (CI) were calculated by linear and logistic regression models, stratified by sex. The interaction effect of education and age on cardiovascular risk factors was tested by including an interaction term. In age-adjusted models, education, occupational position, and income were statistically significantly associated with abdominal obesity in men, and with smoking in both sexes. Men with low education had a more than threefold risk of being a smoker (OR 3.44, CI 1.58-7.51). Low childhood SES was associated with higher systolic blood pressure and abdominal obesity in women (OR 2.27, CI 1.18-4.38 for obesity); a non-significant but (in terms of effect size) relevant association of childhood SES with smoking was observed in men. In women, age was an effect modifier for education in the risk of obesity and smoking. We found considerable differences in cardiovascular risk factors by education, occupational position, income, and partly by childhood social status, differing by sex. Some social inequalities levelled off in higher age. Longitudinal studies are needed to differentiate between age and birth cohort effects. |
| ArticleNumber | 289 |
| Audience | Academic |
| Author | Greiser, Karin H Haerting, Johannes Schumann, Barbara Kluttig, Alexander Werdan, Karl Tiller, Daniel |
| AuthorAffiliation | 4 German Cancer Research Centre, Division of Cancer Epidemiology, 69120 Heidelberg, Germany 2 Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, 901 87 Umeå, Sweden 1 Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, 06097 Halle (Saale), Germany 3 Department of Medicine III, Martin-Luther-University Halle-Wittenberg, 06097 Halle (Saale), Germany |
| AuthorAffiliation_xml | – name: 4 German Cancer Research Centre, Division of Cancer Epidemiology, 69120 Heidelberg, Germany – name: 2 Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, 901 87 Umeå, Sweden – name: 3 Department of Medicine III, Martin-Luther-University Halle-Wittenberg, 06097 Halle (Saale), Germany – name: 1 Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, 06097 Halle (Saale), Germany |
| Author_xml | – sequence: 1 givenname: Barbara surname: Schumann fullname: Schumann, Barbara email: barbara.schumann@epiph.umu.se organization: Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University – sequence: 2 givenname: Alexander surname: Kluttig fullname: Kluttig, Alexander organization: Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg – sequence: 3 givenname: Daniel surname: Tiller fullname: Tiller, Daniel organization: Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg – sequence: 4 givenname: Karl surname: Werdan fullname: Werdan, Karl organization: Department of Medicine III, Martin-Luther-University Halle-Wittenberg – sequence: 5 givenname: Johannes surname: Haerting fullname: Haerting, Johannes organization: Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg – sequence: 6 givenname: Karin H surname: Greiser fullname: Greiser, Karin H organization: Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Division of Cancer Epidemiology, German Cancer Research Centre |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/21569269$$D View this record in MEDLINE/PubMed https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-52340$$DView record from Swedish Publication Index (Umeå universitet) |
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| Keywords | Cardiovascular Risk Factor Social Gradient Systolic Blood Pressure Abdominal Obesity Educational Group |
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Psychosocial pathways to coronary heart disease year: 2002 ident: 3025_CR33 – volume-title: Volkswirtschaftliche Gesamtrechnungen. Nettoeinkommen und Zahl der Haushalte nach Haushaltsgruppen 1991 bis 2002 [National accounts. Net income and number of households by household categories] year: 2003 ident: 3025_CR21 – volume: 29 start-page: 29 year: 2007 ident: 3025_CR6 publication-title: Epidemiol Rev doi: 10.1093/epirev/mxm001 – start-page: 291 volume-title: Coronary Heart Disease Epidemiology. From aetiology to public health year: 2005 ident: 3025_CR13 doi: 10.1093/acprof:oso/9780198525738.003.0021 – volume: 5 start-page: 33 year: 2005 ident: 3025_CR17 publication-title: BMC Cardiovasc Disord doi: 10.1186/1471-2261-5-33 – start-page: 5 volume-title: Stress and the Heart. Psychosocial pathways to coronary heart disease year: 2002 ident: 3025_CR1 – start-page: 47 volume-title: Methods in Social Epidemiology year: 2006 ident: 3025_CR9 – start-page: 17 volume-title: Sozial-Epidemiologie. Einführung in die Grundlagen, Ergebnisse und Umsatzmöglichkeiten year: 2001 ident: 3025_CR11 – volume: 896 start-page: 191 year: 1999 ident: 3025_CR3 publication-title: Ann N Y Acad Sci doi: 10.1111/j.1749-6632.1999.tb08116.x – volume: 59 start-page: 785 year: 2005 ident: 3025_CR29 publication-title: J Epidemiol Community Health doi: 10.1136/jech.2004.029991 – volume: 35 start-page: 814 year: 2000 ident: 3025_CR7 publication-title: Hypertension doi: 10.1161/01.HYP.35.3.814 – volume-title: Demografische Standards, Ausgabe 1999. Eine gemeinsame Empfehlung des Arbeitskreises Deutscher Markt- und Sozialforschungsinstitute e.V. (ADM), der Arbeitsgemeinschaft Sozialwissenschaftlicher Institute e.V. (ASI) und des Statistischen Bundesamtes [Demogra year: 1999 ident: 3025_CR19 – volume: 34 start-page: 335 year: 2005 ident: 3025_CR32 publication-title: Int J Epidemiol doi: 10.1093/ije/dyh394 – start-page: 371 volume-title: A Life Course Approach to Chronic Diseases Epidemiology year: 2004 ident: 3025_CR35 doi: 10.1093/acprof:oso/9780198578154.003.0016 – volume: 34 start-page: 268 year: 2005 ident: 3025_CR4 publication-title: Int J Epidemiol doi: 10.1093/ije/dyh267 – volume: 31 start-page: 21 year: 2009 ident: 3025_CR30 publication-title: Epidemiol Rev doi: 10.1093/epirev/mxp006 – volume: 34 start-page: 327 year: 2005 ident: 3025_CR28 publication-title: Int J Epidemiol doi: 10.1093/ije/dyi007 – volume: 36 start-page: 532 year: 2007 ident: 3025_CR31 publication-title: Int J Epidemiol doi: 10.1093/ije/dyl310 – volume: 34 start-page: 260 year: 2005 ident: 3025_CR34 publication-title: Int J Epidemiol doi: 10.1093/ije/dyh314 – start-page: 32 volume-title: Coronary Heart Disease Epidemiology. From aetiology to public health year: 2005 ident: 3025_CR16 doi: 10.1093/acprof:oso/9780198525738.003.0004 – volume: 23 start-page: 3071 year: 2005 ident: 3025_CR5 publication-title: Circulation – volume: 48 start-page: 1 year: 2007 ident: 3025_CR10 publication-title: J Health Soc Behav doi: 10.1177/002214650704800101 – volume: 46 start-page: 186 year: 2001 ident: 3025_CR24 publication-title: Soz Präventivmedizin doi: 10.1007/BF01324255 – volume: 48 start-page: 191 year: 2003 ident: 3025_CR22 publication-title: Soz Präventivmedizin doi: 10.1007/s00038-003-2055-1 – start-page: 7 volume-title: Messung soziodemographischer Merkmale in der Epidemiologie year: 1998 ident: 3025_CR20 – volume: 119 start-page: 243 year: 2009 ident: 3025_CR14 publication-title: Circulation doi: 10.1161/CIRCULATIONAHA.108.797936 – start-page: 50 volume-title: Sozial-Epidemiologie. Einführung in die Grundlagen, Ergebnisse und Umsatzmöglichkeiten year: 2001 ident: 3025_CR12 – volume: 15 start-page: 262 year: 2005 ident: 3025_CR8 publication-title: Eur J Public Health doi: 10.1093/eurpub/cki115 – volume: 366 start-page: 1640 year: 2005 ident: 3025_CR23 publication-title: Lancet doi: 10.1016/S0140-6736(05)67663-5 – start-page: 3 volume-title: Social Epidemiology year: 2000 ident: 3025_CR2 doi: 10.1093/oso/9780195083316.003.0001 – reference: 15659473 - Int J Epidemiol. 2005 Apr;34(2):335-44 – reference: 17476920 - J Health Soc Behav. 2007 Mar;48(1):1-15 – reference: 16283930 - BMC Cardiovasc Disord. 2005;5:33 – reference: 11565448 - Soz Praventivmed. 2001;46(3):186-94 – reference: 16271645 - Lancet. 2005 Nov 5;366(9497):1640-9 – reference: 19648176 - Epidemiol Rev. 2009;31:21-51 – reference: 17403720 - Eur Heart J. 2007 Apr;28(7):850-6 – reference: 16100318 - J Epidemiol Community Health. 2005 Sep;59(9):785-93 – reference: 15333622 - Int J Epidemiol. 2005 Apr;34(2):260-7 – reference: 12891871 - Soz Praventivmed. 2003;48(3):191-200 – reference: 1585961 - Am J Public Health. 1992 Jun;82(6):816-20 – reference: 15755781 - Eur J Public Health. 2005 Jun;15(3):262-9 – reference: 15956147 - Circulation. 2005 Jun 14;111(23):3022-4 – reference: 19118251 - Circulation. 2009 Jan 20;119(2):243-50 – reference: 19199053 - Eur J Epidemiol. 2009;24(3):123-42 – reference: 15659460 - Int J Epidemiol. 2005 Apr;34(2):327-34 – reference: 17478442 - Epidemiol Rev. 2007;29:29-48 – reference: 17255345 - Int J Epidemiol. 2007 Jun;36(3):532-9 – reference: 10681898 - Ann N Y Acad Sci. 1999;896:191-209 – reference: 15319403 - Int J Epidemiol. 2005 Apr;34(2):268-75 – reference: 16258790 - Z Kardiol. 2005;94 Suppl 3:III/22-9 – reference: 10720600 - Hypertension. 2000 Mar;35(3):814-21 |
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| Snippet | Background
The influence of socioeconomic status (SES) on cardiovascular diseases and risk factors is widely known, although the role of different SES... The influence of socioeconomic status (SES) on cardiovascular diseases and risk factors is widely known, although the role of different SES indicators is not... Background The influence of socioeconomic status (SES) on cardiovascular diseases and risk factors is widely known, although the role of different SES... BACKGROUND: The influence of socioeconomic status (SES) on cardiovascular diseases and risk factors is widely known, although the role of different SES... Abstract Background The influence of socioeconomic status (SES) on cardiovascular diseases and risk factors is widely known, although the role of different SES... |
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| SubjectTerms | Adult Aged Aged, 80 and over Aging - physiology Analysis Anthropometry Biostatistics Blood Pressure - physiology Cardiovascular diseases Cardiovascular Diseases - blood Cardiovascular Diseases - epidemiology Chronic Disease epidemiology Cohort Studies Environmental Health Epidemiology Female Germany - epidemiology Health Status Disparities Humans Hypertension - epidemiology Male Medicine Medicine & Public Health Middle Aged Obesity, Abdominal - epidemiology Physical Examination Prevention Prospective Studies Public Health Regression Analysis Research Article Risk Factors Smoking - epidemiology Social Class Social economics Surveys and Questionnaires Vaccine |
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| Title | Association of childhood and adult socioeconomic indicators with cardiovascular risk factors and its modification by age: the CARLA Study 2002-2006 |
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