In a paper published online recently in the open access journal BMC Public Health, a Brown University assistant professor says that he and his co-authors may be able to help explain the previously documented correlation in developing countries between education and a lower risk of heart disease.
Eric Loucks, an assistant professor of community health at Brown, addressed the question of whether education influences heart disease. “One of the ways to get at that is to see if education is related to the biological underpinnings of heart disease, and one of those is blood pressure.”
In the paper, Loucks and his co-authors analyzed almost 4,000 records from the Framingham Offspring Study.
Controlling just for age, the study’s authors found that women who completed 17 years of school or more had systolic blood pressure readings that were, on average, 3.26 millimeters of mercury (mmHg) lower than women who did not finish high school. Women who went to college, but did not pursue graduate studies, had a 2 mmHg benefit compared to less educated women. For men, going to graduate school versus not finishing high school made a 2.26 mmHg difference, with a lesser benefit for going to college.
Even after controlling for influences such as smoking, drinking, obesity and blood pressure medication, the benefit persisted, although at a lower level (graduate school gave a benefit of 2.86 mmHg for women and 1.25 mmHg for men).
Professor Loucks then went even further in his analysis by indexing the blood pressure readings to make them all equal at the beginning of the 1971-2001 Framingham study period. This statistical maneuver enabled him to determine whether the analysis measured a static difference apparent early on in life or whether the differences increased at all over time. The most educated group of women retained a 2.53 mmHg benefit over the least educated. In men, the difference was much less, only 0.34 mmHg.
That the gender differences are so pronounced and appear to become more so as life goes on suggests that education may have a greater impact on women’s health over their lifetime than on men’s health, Professor Loucks said. That could be because of the correlation between low educational attainment and other health risk factors found in other studies of women.
“Women with less education are more likely to be experiencing depression, they are more likely to be single parents, more likely to be living in impoverished areas and more likely to be living below the poverty line,” Professor Loucks said.
One caveat, he said, is that the population in the study, drawn from the suburban community of Framingham, Massachusetts, decades ago, is disproportionately white and that the conclusions might not generalize to other races.