Role of socioeconomic status (SES) in the long-term association of favorable CVD risk profile with high-sensitivity C-reactive protein (hs-CRP) levels: The Chicago Healthy Aging Study (CHAS)

Background: Higher SES is associated with lower cardiovascular risk. Favorable cardiovascular risk profile (low risk, LR) is associated with lower hs-CRP. The influence of higher vs. lower SES on the association of CVD risk profile with hs-CRP remains unclear.Objective: Assess the relationship of LR profile and subsequent hs-CRP by education (proxy for SES).Design and Methods: Education, CVD risk assessed at baseline (1967-73); hs-CRP measured at follow-up ~40 years post baseline (2009-2011). Education grouped as low education (LE, ≤high school), higher education (HE, some college or more). Participants dichotomized into LR (untreated cholesterol ˂200mg/dl & BP≤120/ ≤80 mmHg, non-diabetic, non-smoking, BMI ˂25kg/m2) vs. non-LR. hs-CRP dichotomized at ˃3mg/l. Logistic regression for ORs, 95% CIs.Results: 1392 participants (28% women, 9% African-American): baseline ages 25-44; follow-up mean age 72; 14.3%, 5.2%, 58.7%, 21.8% were LR-HE, LR-LE, non-LR-HE, non-LR-LE, respectively. Age-sex-race adjusted hs-CRP ˃3mg/dl prevalence 21% for LR-HE and 34% for non-LR-LE (P-value=0.001). LR-HE and LR-LE were ~47% and 53% less likely to have hs-CRP˃3mg/l ~40 years later compared to non-LR-LE (age-sex-race adjusted ORs, 95% CI: 0.53, 0.35-0.80, and 0.47, 0.25-0.85, respectively). High hs-CRP prevalence 21% for LR-HE and 34% for non-LR-LE (P-value=0.001). Non-LR-HE also less likely to have high hs-CRP compared to non-LR-LE (age-sex-race adjusted OR=0.60, 95% CI=0.45-0.81).Conclusion: Likelihood of high CRP was low among LR individuals with both higher and low education; non-LR with higher education also less likely to have high CRP compared to non-LR-LE. More research is needed to understand the influence of SES on hs-CRP.