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Social class differences in coronary heart disease in middle-aged British men: implications for prevention

BACKGROUND: Though social class differences in coronary heart disease (CHD) are well recognized, few studies have assessed the effect of imprecision in social class assessment on the relationship or the overall contribution of social class to attributable CHD risk. METHODS: Prospective observational study of the relationship between occupational social class (assessed at baseline and after 20 years), major CHD (coronary death and non-fatal myocardial infarction) and all-cause mortality rates over 20 years among 5628 middle-aged British men with no previous evidence of CHD. RESULTS: The age-adjusted hazard of major CHD for manual men relative to non-manual men was 1.41 (95% CI: 1.21, 1.64) before correction and 1.50 (95% CI: 1.25, 1.79) after correction for imprecision of social class measurement. The …

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