Please use this identifier to cite or link to this item: https://doi.org/10.1161/JAHA.116.005236
Title: Time trends and educational inequalities in out-of-hospital coronary deaths in Norway 1995-2009: A Cardiovascular Disease in Norway (CVDNOR) project
Authors: Sulo, E
Nygård, O
Vollset, S.E
Igland, J
Ebbing, M
Østbye, T 
Jørgensen, T
Sulo, G
Tell, G.S
Keywords: adult
age
aged
Article
cardiovascular disease
cardiovascular risk
cause of death
controlled study
educational status
female
health disparity
high school
human
incidence
ischemic heart disease
low risk patient
major clinical study
male
middle aged
mortality rate
Norway
out of hospital coronary death
sex
trend study
very elderly
vocational education
age distribution
cause of death
clinical trial
forecasting
mortality
multicenter study
out of hospital cardiac arrest
register
retrospective study
sex ratio
socioeconomics
survival rate
time factor
trends
Adult
Age Distribution
Aged
Aged, 80 and over
Cardiovascular Diseases
Cause of Death
Educational Status
Female
Forecasting
Humans
Incidence
Male
Middle Aged
Norway
Out-of-Hospital Cardiac Arrest
Registries
Retrospective Studies
Sex Distribution
Socioeconomic Factors
Survival Rate
Time Factors
Issue Date: 2017
Citation: Sulo, E, Nygård, O, Vollset, S.E, Igland, J, Ebbing, M, Østbye, T, Jørgensen, T, Sulo, G, Tell, G.S (2017). Time trends and educational inequalities in out-of-hospital coronary deaths in Norway 1995-2009: A Cardiovascular Disease in Norway (CVDNOR) project. Journal of the American Heart Association 6 (2) : e005236. ScholarBank@NUS Repository. https://doi.org/10.1161/JAHA.116.005236
Rights: Attribution 4.0 International
Abstract: Background-Recent time trends and educational gradients characterizing out-of-hospital coronary deaths (OHCD) are poorly described. Methods and Results-We identified all deaths from coronary heart disease occurring outside the hospital in Norway during 1995 to 2009. Time trends were explored using Poisson regression analysis with year as the independent, continuous variable. Information on the highest achieved education was obtained from The National Education Database and classified as primary (up to 10 years of compulsory education), secondary (high school or vocational school), or tertiary (college/university). Educational gradients in OHCD were explored using Poisson regression, stratified by sex and age (< 70 and ?70 years), and results were expressed as incidence rate ratios (IRRs) and 95%CIs. Of 100 783 coronary heart disease deaths, 58.8% were OHCDs. From 1995 to 2009, age-adjusted OHCD rates declined across all education categories (primary, secondary, and tertiary) in younger men (IRR=0.35; 95%CI 0.32-0.38; IRR=0.38; 95%CI 0.35-0.42; IRR=0.33; 95%CI 0.28-0.40), younger women (IRR=0.47; 95% CI 0.40-0.56; IRR=0.55; 95%CI 0.45-0.67; IRR=0.28; 95% CI 0.16-0.47), older men (IRR=0.20; 95%CI 0.19-0.22; IRR=0.20; 95%CI 0.18-0.22; IRR=0.20; 95%CI 0.17-0.23), and older women (IRR=0.26; 95%CI 0.24-0.28; IRR=0.25; 95%CI 0.23-0.28; IRR=0.28; 95%CI 0.22-0.34). Tertiary education was associated with lower risk of OHCD compared to primary education (IRR=0.37; 95%CI 0.35-0.40 in younger men, IRR=0.26; 95%CI 0.22-0.30 in younger women, IRR=0.52; 95%CI 0.49-0.55 in older men, and IRR=0.61; 95%CI 0.57-0.66 in older women). These gradients did not change over time (P interaction=0.25). Conclusions-Although OHCD rates declined substantially during 1995 to 2009, they displayed educational gradients that remained constant over time. © 2017 The Authors.
Source Title: Journal of the American Heart Association
URI: https://scholarbank.nus.edu.sg/handle/10635/178730
ISSN: 20479980
DOI: 10.1161/JAHA.116.005236
Rights: Attribution 4.0 International
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