Relationship between socioeconomic status and stroke: An observational and network Mendelian randomization study

Area of Science:

• Epidemiology
• Genetics
• Public Health

Background:

• The link between socioeconomic status (SES) and stroke risk is debated, with unclear mediating factors.
• Understanding this relationship is crucial for developing effective public health strategies.

Purpose of the Study:

• To investigate the causal relationship between SES and stroke, including subtypes.
• To identify modifiable risk factors that mediate the association between SES and stroke.

Main Methods:

• Utilized UK Biobank data from 372,437 participants over 12.13 years.
• Employed Cox proportional hazards models and two-sample Mendelian randomization (MR).
• Network MR was used to assess mediating roles of risk factors.

Main Results:

• Higher income and education levels were associated with significantly lower risks of stroke and ischemic stroke.
• Hypertension emerged as the primary mediator, explaining a substantial portion of the SES-stroke association.
• Specifically, hypertension mediated 57.12% of income's effect on stroke and 51.24% of income's effect on ischemic stroke.

Conclusions:

• Higher SES causally relates to a reduced risk of stroke and ischemic stroke.
• Interventions targeting hypertension are critical for mitigating stroke risk in lower SES groups.
• Findings underscore the importance of addressing socioeconomic disparities in stroke prevention efforts.