{"id":"2cafee788524","type":"article","url":"https://hartvaat.nl/2026/01/30/lager-opleidingsniveau-hangt-samen-met-meer-halsslagaderplaques-los-van-risicofa/","title":"Lager opleidingsniveau hangt samen met meer halsslagaderplaques, los van risicofactoren (ACE 1950)","title_en":"Association between socioeconomic variables and carotid plaque in middle-aged adults: data from the Akershus Cardiac Examination (ACE) 1950 Study","category":"algemeen","category_label":"Algemeen","professions":["cardioloog","huisarts"],"tags":["acuut-hartfalen","bradycardie","laminopathie","obesitas","ouderen","slaapapneu"],"journal":"Open Heart","doi":"http://openheart.bmj.com/cgi/content/short/13/1/e003865?rss=1","source_url":"https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003865?rss=1","authors":["Bratholm","A. O.","Ihle-Hansen","H.","Vigen","T.","Lyngbakken","M. N.","Omland","T.","Rosjo","H.","Ariansen","I.","Berge","T.","Tveit","A.","Ronningen","P. S."],"significance":5,"published":"2026-01-30","source_date":"2026-01-30","image":"","kennis":["https://hartvaat.nl/kennis/cardiometabool/diabetes-type-1-en-hart/","https://hartvaat.nl/kennis/kleplijden/esc-richtlijn-kleplijden-2021/"],"congress":"","summary_en":"Low socioeconomic status (SES) is linked to higher cardiovascular risk, but its association with carotid atherosclerosis in the general population is less studied. In this cross-sectional analysis of the Norwegian Akershus Cardiac Examination 1950 Study (3,673 participants, mean age 63.9), individual SES was defined by educational attainment and area-level SES by urban/rural residence and municipal median income; carotid ultrasound yielded a plaque score. An elevated plaque score occurred in 23.3% of the highly educated, 28.2% of the secondary-educated and 31.4% of the primary-educated. After adjustment for risk factors, lower-educated women and men retained 22% and 12% more atherosclerotic burden respectively. Area-level SES showed no association. Lower educational attainment is thus associated, independent of classical risk factors, with more carotid atherosclerosis.","created":"2026-07-03T10:32:27Z","updated":"2026-07-03T18:39:25Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een lage sociaaleconomische status (SES) is gekoppeld aan een hoger cardiovasculair risico, maar het verband met halsslagaderatherosclerose in de algemene bevolking is minder onderzocht. In deze cross-sectionele analyse van de Noorse Akershus Cardiac Examination 1950-studie (3.673 deelnemers, gemiddeld 63,9 jaar) werd de individuele SES bepaald via opleidingsniveau en de SES van de woonomgeving via stad/platteland en het mediane inkomen van de gemeente; met halsslagader-echografie werd een plaquescore berekend. Een verhoogde plaquescore kwam voor bij 23,3% van de hoogopgeleiden, 28,2% van de middelbaar opgeleiden en 31,4% van de laagopgeleiden. Na correctie voor risicofactoren hielden laagopgeleide vrouwen en mannen respectievelijk 22% en 12% meer atherosclerotische last. De SES van de woonomgeving toonde geen verband. Een lager opleidingsniveau gaat dus, onafhankelijk van klassieke risicofactoren, gepaard met meer halsslagaderatherosclerose.","abstract_original":"<sec><st>Background</st>\n<p>Low socioeconomic status (SES) is linked to increased cardiovascular risk, but its association with carotid atherosclerosis in the general population is less well studied. We examined associations between individual-level and area-level SES and carotid plaque burden and explored potential sex differences.</p>\n</sec>\n<sec><st>Methods</st>\n<p>In this cross-sectional analysis from the Akershus Cardiac Examination 1950 Study, individual-level SES was defined by educational attainment, and area-level SES by urban versus rural residence and median household income of municipality. Carotid ultrasound was used to quantify plaque burden with a plaque score (0&ndash;3 per segment; maximum 24), where &gt;3 indicates elevated cardiovascular risk. Associations between SES and plaque score were estimated using Poisson regression in crude and adjusted models.</p>\n</sec>\n<sec><st>Results</st>\n<p>We included 3673 participants (48.8% women; mean age 63.9 years). The prevalence of elevated plaque score (&gt;3) was 23.3% in tertiary, 28.2% in secondary and 31.4% in primary education groups (p for trend &lt;0.001). Women and men with primary education had 32% and 24% higher plaque scores than those with tertiary education (p&lt;0.001). After adjustment for cardiovascular risk factors, excess atherosclerotic burden remained 22% in women and 12% in men (p&lt;0.001). No significant associations were observed for area-level SES, and no sex interactions were detected.</p>\n</sec>\n<sec><st>Conclusion</st>\n<p>Lower educational attainment is associated with higher carotid atherosclerotic burden in both sexes, independent of cardiovascular risk factors, while area-level SES shows no clear association. These findings suggest that educational disparities contribute to atherosclerotic disease burden and merit further investigation in longitudinal studies.</p>\n</sec>"}