Occupational status, educational level, and the prevalence of carotid atherosclerosis in a general population sample of middle-aged Swedish men and women: Results from the Malmo Diet and Cancer Study

The associations among educational level, occupational status, and atherosc lerosis were investigated during 1992-1994 in a general population sample o f 4,176 Swedish men and women. Carotid artery intima-media thickness (IMT) and carotid stenosis were determined by B-mode ultrasound. Socioeconomic di fferences in mean carotid IMT and odds ratios for carotid stenosis prevalen ce were estimated. In women, the associations among educational level, occu pational status, and IMT were weak. In men, there was no association betwee n education and IMT, while low occupational status was associated with a th icker IMT. Women with low education had an increased odds of carotid stenos is compared with women with high education (odds ratio (OR) = 2.04, 95% con fidence interval (CI): 1.53, 2.73), while this pattern was weaker among men . Women in manual occupations had an increased odds of carotid stenosis com pared with women in high- or medium-level nonmanual occupations (OR = 1.75, 95% CI: 1.29, 2.36), which could not be seen among men. After adjustment f or risk factors, the association between IMT and occupational status in men disappeared, while the associations among educational level, occupational status, and carotid stenosis in women persisted. The results imply that the atherosclerotic process is associated with socioeconomic status in both se xes, and they also indicate the possibility of sex differences in the mecha nisms connecting socioeconomic status to atherosclerosis.