{
  "abstract": "Background Low socioeconomic status (SES) is linked to increased cardiovascular risk, but its association with carotid atherosclerosis in the general population is less well studied. We examined associations between individual-level and area-level SES and carotid plaque burden and explored potential sex differences.Methods In this cross-sectional analysis from the Akershus Cardiac Examination 1950 Study, individual-level SES was defined by educational attainment, and area-level SES by urban versus rural residence and median household income of municipality. Carotid ultrasound was used to quantify plaque burden with a plaque score (0–3 per segment; maximum 24), where >3 indicates elevated cardiovascular risk. Associations between SES and plaque score were estimated using Poisson regression in crude and adjusted models.Results We included 3673 participants (48.8% women; mean age 63.9 years). The prevalence of elevated plaque score (>3) was 23.3% in tertiary, 28.2% in secondary and 31.4% in primary education groups (p for trend <0.001). Women and men with primary education had 32% and 24% higher plaque scores than those with tertiary education (p<0.001). After adjustment for cardiovascular risk factors, excess atherosclerotic burden remained 22% in women and 12% in men (p<0.001). No significant associations were observed for area-level SES, and no sex interactions were detected.Conclusion Lower educational attainment is associated with higher carotid atherosclerotic burden in both sexes, independent of cardiovascular risk factors, while area-level SES shows no clear association. These findings suggest that educational disparities contribute to atherosclerotic disease burden and merit further investigation in longitudinal studies.",
  "authors": [
    {
      "affiliations": [
        "Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway",
        "Institute of Clinical Medicine, University of Oslo, Oslo, Norway"
      ],
      "name": "Åsmund Olaf Bratholm"
    },
    {
      "affiliations": [
        "Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway"
      ],
      "name": "Håkon Ihle-Hansen"
    },
    {
      "affiliations": [
        "Department of Neurology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway"
      ],
      "name": "Thea Vigen"
    },
    {
      "affiliations": [
        "Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway",
        "K.G. Jebsen Centre for Cardiac Biomarkers, Institute of Clinical Medicine, University of Oslo, Oslo, Norway"
      ],
      "name": "Magnus Nakrem Lyngbakken"
    },
    {
      "affiliations": [
        "Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway",
        "K.G. Jebsen Centre for Cardiac Biomarkers, Institute of Clinical Medicine, University of Oslo, Oslo, Norway"
      ],
      "name": "Torbjorn Omland"
    },
    {
      "affiliations": [
        "K.G. Jebsen Centre for Cardiac Biomarkers, Institute of Clinical Medicine, University of Oslo, Oslo, Norway",
        "Akershus Clinical Research Centre, Division for Research and Innovation, Akershus University Hospital, Lørenskog, Norway"
      ],
      "name": "Helge Røsjø"
    },
    {
      "affiliations": [
        "Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway"
      ],
      "name": "Inger Ariansen"
    },
    {
      "affiliations": [
        "Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway"
      ],
      "name": "Trygve Berge"
    },
    {
      "affiliations": [
        "Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway",
        "Institute of Clinical Medicine, University of Oslo, Oslo, Norway"
      ],
      "name": "Arnljot Tveit"
    },
    {
      "affiliations": [
        "Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway"
      ],
      "name": "Peter Selmer Rønningen"
    }
  ],
  "title": "Association between socioeconomic variables and carotid plaque in middle-aged adults: data from the Akershus Cardiac Examination (ACE) 1950 Study",
  "uid": "b051d761-3b27-5869-9f83-302428ab133c"
}