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Inverse Association between Educational Status and Coronary CT Calcium Scores: Should We Reflect This in Our ASCVD Risk Assumptions?

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  • Christiane Dienhart

    (Department of Internal Medicine I, Paracelsus Medical University, 5020 Salzburg, Austria)

  • Bernhard Paulweber

    (Department of Internal Medicine I, Paracelsus Medical University, 5020 Salzburg, Austria
    Obesity Research Unit, Paracelsus Medical University, 5020 Salzburg, Austria)

  • Vanessa N. Frey

    (Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, 5020 Salzburg, Austria)

  • Bernhard Iglseder

    (Department of Geriatric Medicine, Christian Doppler University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria)

  • Eugen Trinka

    (Department of Internal Medicine I, Paracelsus Medical University, 5020 Salzburg, Austria
    Department of Public Health, Health Services Research & Health Technology Assessment, UMIT—University for Health Sciences, Medical Informatics & Technology, 6060 Hall in Tirol, Austria
    Centre for Cognitive Neuroscience, Neuroscience Institute, Christian Doppler University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria)

  • Patrick Langthaler

    (Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, 5020 Salzburg, Austria)

  • Elmar Aigner

    (Department of Internal Medicine I, Paracelsus Medical University, 5020 Salzburg, Austria)

  • Marcel Granitz

    (CT und MRT Institut, DBS Gmbh, 5020 Salzburg, Austria)

  • Bernhard Wernly

    (Institute for General and Preventive Medicine, Paracelsus Medical University, 5020 Salzburg, Austria)

Abstract

Education is not a factor included in most cardiovascular risk models, including SCORE2. However, higher education has been associated with lower cardiovascular morbidity and mortality. Using CACS as a proxy for ASCVD, we studied the association between CACS and educational status. Subjects, aged 40–69, from the Paracelsus 10,000 cohort, who underwent calcium scoring as part of screening for subclinical ASCVD, were classified into low, medium, and high educational status using the Generalized International Standard Classification of Education. CACS was dichotomised as either 0 or >0 for logistic regression modelling. Our analysis showed that higher educational status was associated with higher odds for 0 CACS (aOR 0.42; 95%CI 0.26–0.70; p = 0.001). However, there was no statistically significant association between the levels of total, HDL or LDL cholesterol and educational status, nor any statistical differences in HbA1c. SCORE2 did not differ between the three educational categories (4 ± 2% vs. 4 ± 3% vs. 4 ± 2%; p = 0.29). While our observations confirmed the relationship between increased educational status and lower ASCVD risk, the effect of educational status was not mediated via its impact on classical risk factors in our cohort. Thus, perhaps educational status should be taken into account to more accurately reflect individual risk in cardiovascular risk models.

Suggested Citation

  • Christiane Dienhart & Bernhard Paulweber & Vanessa N. Frey & Bernhard Iglseder & Eugen Trinka & Patrick Langthaler & Elmar Aigner & Marcel Granitz & Bernhard Wernly, 2023. "Inverse Association between Educational Status and Coronary CT Calcium Scores: Should We Reflect This in Our ASCVD Risk Assumptions?," IJERPH, MDPI, vol. 20(12), pages 1-9, June.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:12:p:6065-:d:1165113
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    References listed on IDEAS

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    1. Silke L. Schneider, 2022. "The classification of education in surveys: a generalized framework for ex-post harmonization," Quality & Quantity: International Journal of Methodology, Springer, vol. 56(3), pages 1829-1866, June.
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