Association of Socioeconomic Status With Functional Capacity, Heart Rate Recovery, and All-Cause Mortality

CONTEXT Lower socioeconomic status (SES) confers heightened cardiovascular risk and mortality, although the mediating pathways are unclear. OBJECTIVE To evaluate the extent to which exercise physiologic characteristics account for the association between lower SES and mortality. DESIGN, SETTING, AND...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2006-02, Vol.295 (7), p.784-792
Main Authors: Shishehbor, Mehdi H, Litaker, David, Pothier, Claire E, Lauer, Michael S
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Blood pressure
Cardiovascular disease
Cardiovascular Diseases - epidemiology
Cardiovascular Physiological Phenomena
Cohort Studies
Exercise Test
Female
General aspects
Health care policy
Heart Rate
Home ownership
Humans
Income
Logistic Models
Male
Medical sciences
Middle Aged
Mortality
Ohio
Patients
Risk factors
Socioeconomic Factors
Status
Testing
Variables
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Summary:CONTEXT Lower socioeconomic status (SES) confers heightened cardiovascular risk and mortality, although the mediating pathways are unclear. OBJECTIVE To evaluate the extent to which exercise physiologic characteristics account for the association between lower SES and mortality. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study of 30 043 consecutive patients living in 7 counties in northeast Ohio referred between 1990 and 2002 for symptom-limited stress testing for evaluation of known or suspected coronary artery disease. Follow-up for mortality continued through February 2004. MAIN OUTCOME MEASURES Estimated functional capacity in metabolic equivalents and heart rate recovery, physiologic characteristics that are determined directly from exercise; testing and all-cause mortality during a median follow-up of 6.5 years. RESULTS Multivariable models adjusting for demographics, insurance status, smoking status, and clinical confounders demonstrated a strong association between a composite SES score based on census block data and functional capacity (adjusted odds ratio comparing 25th with 75th percentile values, 1.72; 95% confidence interval [CI], 1.56-1.89; P
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.295.7.784