Do lifestyle behaviours explain socioeconomic differences in all-cause mortality, and fatal and non-fatal cardiovascular events? Evidence from middle aged men in France and Northern Ireland in the PRIME Study

• Published in: Preventive medicine 2012-03, Vol.54 (3), p.247-253
• Main Authors: Woodside, J.V, Yarnell, J.W.G, Patterson, C.C, Arveiler, D, Amouyel, P, Ferrières, J, Kee, F, Evans, A, Bingham, A, Ducimetière, P
• Format: Article
• Language: English
• Subjects: Age; Alcohol; Alcohol Drinking - epidemiology; Analysis of Variance; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - mortality; Chi-Square Distribution; Coronary heart disease incidence; Diet - statistics & numerical data; France; France - epidemiology; Fruits; Humans; Internal Medicine; Life Style; Lifestyle; Lifestyle behaviours; Male; Males; Middle Aged; Middle aged men; Mortality; Motor Activity; Northern Ireland; Northern Ireland - epidemiology; Physical activity; Proportional Hazards Models; Prospective Studies; Risk factors; Smoking; Smoking - epidemiology; Socioeconomic factors; Socioeconomic status; Socioeconomics; Statistics, Nonparametric
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1016/j.ypmed.2012.01.017

Abstract Objective To examine the contribution of lifestyle behaviours to the socioeconomic gradient in all-cause mortality, and fatal and non-fatal cardiovascular events. Method 10,600 men aged 50–59 years examined in 1991–1994 in Northern Ireland (NI) and France and followed annually for deaths and cardiovascular events for 10 years. Baseline smoking habit, physical activity, and fruit, vegetable, and alcohol consumption were assessed. Results All lifestyle behaviours showed marked socioeconomic gradients for most indicators in NI and France, with the exception of percentage of alcohol consumers in NI and frequency of alcohol consumption in NI and France. At 10 years, there were 544 deaths from any cause and 440 fatal and non-fatal cardiovascular events. After adjustment for country and age, socioeconomic gradients were further adjusted for lifestyle behaviours. For total mortality, the median residual contribution of lifestyle behaviours was 28% and for cardiovascular incidence, 41%. When cardiovascular risk factors were considered in conjunction with lifestyle behaviours these percentages increased to 38% and 67% respectively. Conclusion Lifestyle behaviours contribute to the gradient in mortality and cardiovascular incidence between socioeconomic groups, particularly for cardiovascular incidence, but a substantial proportion of these differentials was not explained by lifestyle behaviours and cardiovascular risk factors.