The association between socioeconomic status and subclinical atherosclerosis in a rural Bangladesh population

- There is a rising incidence of cardiovascular disease in Bangladesh.
- The relationship between cardiovascular disease and socioeconomic status is unknown.
- In Bangladesh, subclinical cardiovascular disease is linked to occupation status.

BackgroundIn Bangladesh, CVD accounts for the majority of non-communicable mortality. The purpose of this study was to determine the role of socioeconomic status (SES) on subclinical atherosclerosis measured as carotid intima-media thickness (IMT) in a rural Bangladesh population.MethodsCarotid IMT was measured between 2010 and 2011 in 1022 participants (average age 46, 40% male) randomly selected from the Health Effects of Arsenic Longitudinal Study (HEALS), a population-based prospective cohort study based in rural Bangladesh. SES was measured as occupation type, land ownership, educational attainment, and television ownership.ResultsHalf of the participants received formal education (53%) and under half owned land (48%) and a television (44%). Women were primarily homemakers (95%) and men worked as factory workers (24%), laborers (18%), or in business (55%). In univariate analysis, those owning greater than one acre of land (p = 0.03), owning a television (p = 0.02), or laborers and business owners compared to factory workers had higher levels of carotid IMT (p < 0.01). In multivariate analysis after adjustment for confounders, only men employed in the business sector had elevated carotid IMT compared to factory workers. The association was strongest in older men (58.7 μm, 95% CI 17.2-100.0, ≥ 50 years old) compared to younger men (13.7 μm, 95% CI − 7.8-35.2, < 50 years old).ConclusionBusiness sector employment was positively associated with subclinical atherosclerosis after adjustment for confounders. This finding is consistent with evidence from other developing nations suggesting that certain SES factors are independent predictors of CVD.