Much of the social inequality in heart disease risk among UK women is due to smoking, obesity and physical inactivity | University of Oxford

Much of the social inequality in heart disease risk among UK women is due to smoking, obesity and physical inactivity

13 October 2016

Women with lower levels of education and living in more deprived areas of the UK are at greater risk of coronary heart disease, and this is largely due to smoking, obesity and physical inactivity, according to a study of over a million women published in the open access journal BMC Medicine.

Lead author Dr Sarah Floud, from the Cancer Epidemiology Unit in the Nuffield Department of Population Health at the University of Oxford, said: ‘Women with fewer educational qualifications and from more deprived areas of the UK were more likely to smoke, be obese and be physically inactive, although they consumed slightly less alcohol. We found that these factors accounted for most of the social inequalities in heart disease risk. The most important factor, however, was smoking: it alone accounted for about half of the associations of heart disease with education and deprivation.’

The study included 1.2 million participants from the Million Women Study – about one in four of all UK women born in the 1930s and 1940s. During 12 years of follow-up, 72,000 women developed heart disease. The large numbers made it possible to look carefully at the extent to which four lifestyle factors – smoking, alcohol consumption, physical activity and body mass index – accounted for the known social inequalities in heart disease.

The researchers found that, without taking into account the four lifestyle factors, women who had completed compulsory schooling with no qualifications had almost twice the risk of developing heart disease or dying from it than women who had a degree. Similarly, women in the most deprived areas had twice the risk of heart disease compared with women from the least deprived areas. After taking into account the lifestyle factors, the differentials in risk diminished.

Dr Floud added: ‘It is important to recognise that these health-related behaviours are themselves influenced by education and deprivation, and that it is harder to change them if you don’t have the resources to do so.’

The results underline the importance of existing public health policies to reduce smoking and to promote healthy eating and increased physical activity. The more disadvantaged members of society are often the hardest to reach but the findings from this study emphasize the potential gains that could be made in reducing rates of heart disease if they are reached.

For further information, please contact Stuart Gillespie in the University of Oxford press office at stuart.gillespie@admin.ox.ac.uk or on +44 (0)1865 283877.

Dr Sarah Floud: sarah.floud@ceu.ox.ac.uk

Notes to editors:

  • ‘The role of health-related behavioural factors in accounting for inequalities in coronary heart disease risk by education and area deprivation: prospective study of 1.2 million UK women’,
  • Sarah Floud, Angela Balkwill, Kath Moser, Gillian K Reeves, Jane Green, Valerie Beral, Benjamin J. Cairns, BMC Medicine.
  • During the embargo period, the article is available here: 
    http://bit.ly/2djkVcK

    After the embargo lifts, the article will be available at the journal website here:
    https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0687-2
  • The Million Women Study is funded by the UK Medical Research Council and Cancer Research UK.
  • The University of Oxford’s Medical Sciences Division is one of the largest biomedical research centres in Europe, with over 2,500 people involved in research and more than 2,800 students. The University is rated the best in the world for medicine, and it is home to the UK’s top-ranked medical school. From the genetic and molecular basis of disease to the latest advances in neuroscience, Oxford is at the forefront of medical research. It has one of the largest clinical trial portfolios in the UK and great expertise in taking discoveries from the lab into the clinic. Partnerships with the local NHS Trusts enable patients to benefit from close links between medical research and healthcare delivery. A great strength of Oxford medicine is its long-standing network of clinical research units in Asia and Africa, enabling world-leading research on the most pressing global health challenges such as malaria, TB, HIV/AIDS and flu. Oxford is also renowned for its large-scale studies which examine the role of factors such as smoking, alcohol and diet on cancer, heart disease and other conditions.
  • BMC Medicine is an open access, open peer-reviewed general medical journal publishing outstanding and influential research in all areas of clinical practice, translational medicine, public health, policy, and general topics of interest to the biomedical research community. As the flagship medical journal of the BMC series, we also publish stimulating debates and reviews as well as unique forum articles and concise tutorials.
  • * BioMed Central is an STM (Science, Technology and Medicine) publisher which has pioneered the open access publishing model. All peer-reviewed research articles published by BioMed Central are made immediately and freely accessible online, and are licensed to allow redistribution and reuse. BioMed Central is part of Springer Nature, a major new force in scientific, scholarly, professional and educational publishing, created in May 2015 through the combination of Nature Publishing Group, Palgrave Macmillan, Macmillan Education and Springer Science+Business Media. www.biomedcentral.com