Less educated women face a greater risk of developing heart disease, research from Sweden shows. This is largely because women with fewer years of schooling are more likely to have heart disease risk factors such as cigarette smoking, sedentary lifestyle, high body mass index, high blood pressure and diabetes, researchers report.

There is a well-established link between lower socioeconomic status and higher heart disease risk among men, the research team notes in the American Journal of Epidemiology. A number of causes have been proposed for the connection, including that less educated, poorer people may have unhealthier lifestyles or less access to medical care, or that they may face more on-the-job stress.

To investigate the relationship between social status and heart disease in women, Dr. Hannah Kuper of the London School of Hygiene and Tropical Medicine in the UK and colleagues analyzed data from a study of 49,259 women who ranged in age from 30 to 50 at the study’s outset in 1991-1992 and had been followed for an average of 11 years.

Women with the least education were more than three times as likely as those with the most years of schooling to have a heart attack during the follow-up period, the researchers found. Nearly all of this relationship could be attributed to the higher prevalence of heart disease risk factors such as smoking and overweight among the less educated women.

The researchers also found a weak relationship between increased job stress and lower social support on the job and heart disease risk, but this relationship could not account for the heart disease-education link.

They conclude: “A health promotion campaign aimed at reducing the prevalence of established coronary risk factors such as smoking in lower educational groups may reduce the population incidence of coronary heart disease, although other correlates of low education need further investigation.”

SOURCE: American Journal of Epidemiology, August 15, 2006.