Stroke: lower socioeconomic class increased the risk of a stroke

Clinical bottom line (level 1b)

  1. One in fourteen working men had a stroke in the next 25 years.
  2. The risk was increased with a lower socioeconomic class.
Hart et al: Stroke 2000; 31 : 2093-2097
Expires November 2003

The study

Prospective cohort study with ?objective ?blinded outcomes, adjusted for confounding factors, not validated in an independent set of patients.

Setting: 27 workplaces, Scotla nd

5765 patients (aged , 100% male) admitted to hospital or died with a stroke

Excluded if
  • data missing


Factors studied:
  • age, sex, FEV1, blood pressure, height, alcohol consumption, pre-existing coronary heart disease
  • manual class III compared with class I, II, III non-manual
  • class IV and V

    Social class based on father's occupation.

    A proportional hazards regression model used to adjust for confounding factors.

    100% followed for 25 years
    Outcomes studied:
  • stroke

    The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)    		 NNF
    (95% CI)
    stroke 25 years 416/5765 7.2%
    (6.5% to 7.9%)    		 14
    (13 to 15)

    prognostic factor for
    stroke     		time to outcome adjusted RR
    (95% CI)    		 NNF+
    (95% CI)
    manual class III 25 years 1.37
    (1.03 to 1.81)     		54
    (25 to 660)
    class IV and V 25 years 1.46
    (1.09 to 1.96)     		43
    (21 to 220)

    Citation

    1. Hart CL, Hole DJ, Davey Smith G: influence of socioeconomic circumstances in early and later life on stroke risk among men in a Scottish Cohort study. Stroke 2000; 31 : 2093-2097
    Search Terms:
    Contributor: Chris Ball, November 2001
    Reviewer:

    Clinical Question.
    Patient working man
    Intervention or Exposure socioeconomic class
    Outcome stroke
    		•