Life course socioeconomic adversities and 10-year risk of cardiovascular disease: cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health.

Abstract

Objectives To investigate whether life course exposure to adverse socioeconomic positions (SEP) as well as maintaining a low SEP or decreasing the SEP intra- and intergeneration was associated with an increased 10-year cardiovascular disease (CVD) risk predicted by the Framingham Risk Score. Methods This is a cross-sectional analysis of baseline data (2008–2010) of 13,544 active workers from ELSA-Brasil cohort. Maternal education, leg length, social class of first occupation and education were used to evaluate childhood, youth and adulthood SEP. Results After considering adulthood SEP, exposure to early-life low SEP remained associated with an increased 10-year CVD risk. The 10-year CVD risk also rose as the number of exposures to low SEP throughout life increased. Compared to individuals in high-stable intragenerational trajectory, those in upward, downward, or stable low trajectory presented higher 10-year CVD risk. Increasing individuals’ SEP over generation showed no increased risk of 10-year CVD risk compared to individuals in highstable trajectory. Conclusions Childhood may be a critical period for exposures to social adversities. Life course low SEP may also affect the 10-year CVD risk via accumulation of risk and social mobility.