# Lager opleidingsniveau hangt samen met meer halsslagaderplaques, los van risicofactoren (ACE 1950)

*geplaatst 2026-01-30 · Algemeen · Open Heart · doi http://openheart.bmj.com/cgi/content/short/13/1/e003865?rss=1 · https://hartvaat.nl/2026/01/30/lager-opleidingsniveau-hangt-samen-met-meer-halsslagaderplaques-los-van-risicofa/*

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.

## English: Association between socioeconomic variables and carotid plaque in middle-aged adults: data from the Akershus Cardiac Examination (ACE) 1950 Study

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.

## Abstract (original, from the publication)

<sec><st>Background</st>
<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>
</sec>
<sec><st>Methods</st>
<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>
</sec>
<sec><st>Results</st>
<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>
</sec>
<sec><st>Conclusion</st>
<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>
</sec>

Auteurs: Bratholm, A. O., Ihle-Hansen, H., Vigen, T., Lyngbakken, M. N., Omland, T., Rosjo, H., Ariansen, I., Berge, T., Tveit, A., Ronningen, P. S.

---
Bron: Open Heart, https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003865?rss=1. Bijgewerkt 2026-07-03T18:39:25Z. 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.