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Education and coronary heart disease: mendelian randomisation study
Taavi Tillmann1, Julien Vaucher2, Aysu Okbay3
1Department of Epidemiology and Public Health, University College London, London, UK t.tillmann@ucl.ac.uk.
BMJ (Clinical Research Ed.)
|September 1, 2017
Summary
Higher educational attainment causally reduces coronary heart disease risk by one third. This study suggests increasing education may offer significant cardiovascular health benefits.
Area of Science:
- Cardiovascular Epidemiology
- Genetic Epidemiology
- Social Determinants of Health
Background:
- Educational attainment is linked to coronary heart disease (CHD) risk, but causality is debated due to confounding factors.
- Mendelian randomization (MR) offers a method to investigate causal relationships using genetic variants as instrumental variables.
- Understanding the causal impact of education on CHD is crucial for public health interventions.
Purpose of the Study:
- To determine if educational attainment is a causal risk factor for coronary heart disease (CHD).
- To investigate the causal effect of education on common cardiovascular risk factors.
Main Methods:
- A Mendelian randomization study utilizing genetic data from large consortia (CARDIoGRAMplusC4D, SSGAC) with 543,733 participants.
- Genetic variants associated with education (162 variants) were used as proxies for educational attainment (3.6 years increase per SD).
- Results were compared with traditional observational studies and sensitivity analyses were performed.
Main Results:
- A genetic predisposition for 3.6 years of additional education was associated with a 33% lower risk of coronary heart disease (OR 0.67).
- This finding aligns with observational studies, suggesting a causal link.
- Increased genetic predisposition for education correlated with reduced smoking, lower body mass index, and improved blood lipid profiles.
Conclusions:
- Low educational attainment appears to be a causal risk factor for coronary heart disease.
- Potential mediating mechanisms include smoking, body mass index, and blood lipids.
- Increasing educational opportunities may lead to substantial improvements in cardiovascular health.
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