Stroke risk higher in less well-educated women

A study involving Swedish women indicates that the risk of stroke has a marked inverse correlation with years of education, European researchers report in the journal Stroke.

"This study," lead investigator Dr. Hannah Kuper told Reuters Health, "shows a dramatically higher incidence of stroke in the least educated women compared to the risk among the most educated."

"Most of the gradient," she added, "can be attributed to differences in health behaviors such as smoking and alcohol consumption."

Kuper of the London School of Hygiene and Tropical Medicine and colleagues analyzed data from almost 48,000 women aged 30 to 50 years at the outset who were followed for about ten years. Educational level was used as a proxy for socioeconomic status.

The women completed an extensive questionnaire and were traced through linkages to national registries. During this period, there were 200 cases of stroke.

The risk of stroke was significantly inversely related to years of education completed. The hazard ratio was 2-fold higher for the least educated compared to the most educated women.

This association was reduced after adjustment for established risk factors, although it remained significant. Psychosocial factors did not contribute to the difference in stroke risk.

"This finding is encouraging," continued Kuper, "as it suggests that through health promotion and the uptake of a healthier lifestyle, the risk of stroke among the least educated women could fall to that approaching the risk in the most educated group."

The author of an accompanying editorial, Dr. Tobias Kurth of Harvard Medical School, Boston told Reuters Health "traditional stroke risk factors explained a substantial amount of the increased risk."

Nevertheless, he concluded, "policymakers must be made aware of how socioeconomic status influences stroke and other disease risk and use this information to target these easily identifiable groups."

SOURCE: Stroke January 2007.