Résumé :
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[BDSP. Notice produite par INIST Ibn3HR0x. Diffusion soumise à autorisation]. Objectives-To determine the impact of socioeconomic status (SES) on coronary heart disease (CHD) mortality in people with and without prevalent CHD at baseline. Design-Cohort study with 25 year follow up ; prevalent CHD was defined by Q, ST or T wave electrocardiographic (ECG) abnormalities or symptoms (defined by the Rose chest pain questionnaire and self reported doctor diagnosis) or both. SES was defined by four civil service employment grades. Setting-London. Participants-17 907 male civil servants aged 40-69 years. Main outcome measures-CHD mortality (n=2695 deaths). Results-The lowest versus highest employment grade was associated with increased CHD mortality (age adjusted hazard ratio 1.56 (95% CI 1.2,2.1)), prevalence of symptoms and, among symptomatic participants only, the prevalence of Q, ST or T abnormalities. Thirty one per cent of CHD deaths occurred in participants with prevalent CHD at baseline. Among participants without Q, ST or T abnormality employment grade was associated with CHD mortality ; the hazard ratios (lowest v highest grade) adjusted for age, systolic and diastolic blood pressure were 1.72 (95% CI 1.4,2.1) for asymptomatic and 1.52 (95% CI 1.1,2.1) for symptomatic participants ; among participants with Q, ST or T abnormality the corresponding hazard ratios were 1.46 (95% CI 0.7,2.9) and 1.14 (95% CI 0.6,2.0) respectively. (...)
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