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Education protects against coronary heart disease and stroke independently of cognitive function: evidence from Mendelian randomization.

Gill, D; Efstathiadou, A; Cawood, K; Tzoulaki, I; Dehghan, A (2019) Education protects against coronary heart disease and stroke independently of cognitive function: evidence from Mendelian randomization. Int J Epidemiol, 48 (5). pp. 1468-1477. ISSN 1464-3685 https://doi.org/10.1093/ije/dyz200
SGUL Authors: Gill, Dipender Preet Singh

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Abstract

BACKGROUND: There is evidence that education protects against cardiovascular disease. However, it is not known whether such an effect is independent of cognition. METHODS: We performed two-sample Mendelian randomization (MR) analyses to investigate the effect of education and cognition, respectively, on risk of CHD and ischaemic stroke. Additionally, we used multivariable MR to adjust for the effects of cognition and education in the respective analyses to measure the effects of these traits independently of each other. RESULTS: In unadjusted MR, there was evidence that education is causally associated with both CHD and stroke risk [CHD: odds ratio (OR) 0.65 per 1-standard deviation (SD; 3.6 years) increase in education; 95% confidence interval (CI) 0.61-0.70, stroke: OR 0.77; 95% CI 0.69-0.86]. This effect persisted after adjusting for cognition in multivariable MR (CHD: OR 0.76; 95% CI 0.65-0.89, stroke OR 0.74; 95% CI 0.59-0.92). Cognition had an apparent effect on CHD risk in unadjusted MR (OR per 1-SD increase 0.80; 95% CI 0.74-0.85), however after adjusting for education this was no longer observed (OR 1.03; 95% CI 0.86-1.25). Cognition did not have any notable effect on the risk of developing ischaemic stroke, with (OR 0.97; 95% CI 0.87-1.08) or without adjustment for education (OR 1.04; 95% CI 0.79-1.36). CONCLUSIONS: This study provides evidence to support that education protects against CHD and ischaemic stroke risk independently of cognition, but does not provide evidence to support that cognition protects against CHD and stroke risk independently of education. These findings could have implications for education and health policy.

Item Type: Article
Additional Information: © The Author(s) 2019. Published by Oxford University Press on behalf of the International Epidemiological Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Mendelian randomization, cognition, coronary heart disease, education, stroke, Body Mass Index, Cognition, Coronary Disease, Educational Status, Genome-Wide Association Study, Humans, Mendelian Randomization Analysis, Phenotype, Polymorphism, Single Nucleotide, Risk Factors, Stroke, Humans, Coronary Disease, Body Mass Index, Risk Factors, Cognition, Phenotype, Polymorphism, Single Nucleotide, Educational Status, Stroke, Genome-Wide Association Study, Mendelian Randomization Analysis, 0104 Statistics, 1117 Public Health and Health Services, Epidemiology
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Int J Epidemiol
ISSN: 1464-3685
Language: eng
Dates:
DateEvent
1 October 2019Published
28 September 2019Published Online
13 September 2019Accepted
Publisher License: Creative Commons: Attribution 4.0
PubMed ID: 31562522
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/112807
Publisher's version: https://doi.org/10.1093/ije/dyz200

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