A man’s heart and a wife’s education: A 12-year coronary heart disease mortality follow-up in Norwegian men

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Abstract
Background Low socioeconomic status is an established risk factor for coronary heart disease. Yet relatively few studies have examined whether wives’ socioeconomic status may influence men’s coronary heart disease (CHD) risk factors and mortality. We examined whether wives’ education was associated with men’s risk of CHD after taking into account the men’s own educational level. Methods Married men were identified in a population-based cohort recruited for a cardiovascular disease screening conducted 1977–1983 in three Norwegian counties. Differences in baseline risk factors and subsequent CHD mortality by men’s and their wives’ education were examined. The cohort was followed through 1992. Results Wives’ education was inversely related to the prevalence of men’s sedentary behaviour, being overweight, having a high diastolic blood pressure, blood pressure treatment, and high total cholesterol and smoking in logistic regression analyses adjusting for men’s age and education. For smoking and obesity, we observed a significant men’s by wives’ education interaction, with stronger inverse trends observed by wives’ education among the higher-educated men. In prospective analyses, men’s age-adjusted CHD mortality rates decreased with increasing level of wives’ education within each stratum of men’s education, with the exception of men in the lowest (7 years) education category where no trend by wives’ education was observed. In additional multivariate analyses, adjusting for numerous baseline risk factors, the inverse trend in men’s CHD mortality by wives’ educational level remained significant only among men in the highest education category (≥11 years of education). Conclusions The data suggest that a partner’s educational level could add valuable information to studies designed to characterize and measure the influence of socioeconomic status. Also, our data do not support other studies reporting that educated wives are hazardous for men’s hearts.