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Cate Swannell
Med J Aust 2017; 207 (5): . || doi: 10.5694/mja17.n0409
Published online: 4 September 2017

Researchers at the Murdoch Childrens Research Institute have found that children from socially and economically disadvantaged families and neighbourhoods are more likely to have thicker carotid artery walls, which may a indicate higher risk of heart attack and stroke in later life. The research, published in the Journal of the American Heart Association, analysed both family and neighbourhood socio-economic position data from 1477 Australian families. Socio-economic measures included income, education and the occupation of parents, as well as the relative socio-economic status of the immediate neighbourhood. Between the ages of 11 and 12 years, each child’s right carotid artery was imaged and the maximum carotid intima media thickness measured. The study found that both family and neighbourhood socio-economic position were statistically associated with the thickness of the carotid artery inner layer, but the family association was stronger; at age 11–12, children from families in the lowest socio-economic quartile (most disadvantaged) were 46% more likely to have thicker carotid measurements (above the 75th percentile). Further, socio-economic status as early as age 2–3 years was linked with thicker carotid artery measurements at age 11–12. The researchers noted that their findings were not modified after adjusting for traditional cardiovascular risk factors, including body weight, blood pressure and exposure to second hand smoke. Based on findings from their other investigations, the authors proposed that infection and inflammation may be among the additional underlying factors. Infection, which leads to inflammation, is more common among people who are socio-economically disadvantaged, they noted. The authors wrote that, given the link between socio-economic status during infancy and carotid artery measurements in mid-childhood, it may be that cardiovascular disease risk increases before the baby is born. As this was an observational study, a cause-and-effect association between socio-economic position and carotid intima media thickness could not be established. It is also not yet known whether thicker carotid arteries in mid-childhood are linked with cardiovascular risk during adulthood. All study participants were Australians, which may limit the application of findings to other populations.




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