Finding that patients who have not finished high school have a 2.4 percent higher risk of dying of coronary heart disease than those with more schooling, Kevin Fiscella, M.D., M.P.H. and colleagues suggest that educational level of less that 12 years should be incorporated into the current CHD treatment guidelines.
The findings were drawn from a prospective cohort study of 6,479 adults aged 25 to 74 years who participated in the National Health and Nutrition Examination Survey and for whom ascertainment of risk factors and 10-year status was available.
The authors point out that the risk associated with low education level is comparable in magnitude to many of the traditional risk factors, including cholesterol level, smoking status, sex and age, which are included in the current treatment guidelines.
The authors suggest that use of low education level to identify persons at higher risk of CHD, who are not otherwise identifiable under current guidelines, may facilitate progress toward individualized treatment and the elimination of socioeconomic disparities in health.
Annals of Family Medicine is a peer-reviewed research journal that provides a cross-disciplinary forum for new, evidence-based information affecting the primary care discipline. Launched in May 2003, the journal is sponsored by six family medical organizations, including the American Academy of Family Physicians, the American Board of Family Practice, the Society of Teachers of Family Medicine, the Association of Departments of Family Medicine, the Association of Family Practice Residency Directors and the North American Primary Care Research Group. The journal is published six times each year and contains original research from the clinical, biomedical, social and health services areas, as well as contributions on methodology and theory, selected reviews, essays and editorials. A board of directors with representatives from each of the sponsoring organizations oversees Annals. Complete editorial content and interactive discussion groups can be accessed free of charge on the journal's Web site, www.annfammed.org.
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