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(Stroke. 1999;30:357-362.)
© 1999 American Heart Association, Inc.


Original Contributions

Socioeconomic Differences in Stroke Among Dutch Elderly Women

The Rotterdam Study

Caroline T. M. van Rossum, MSc; Hendrike van de Mheen, PhD; Monique M. B. Breteler, MD, PhD; Diederick E. Grobbee, MD, PhD Johan P. Mackenbach, MD, PhD

From the Departments of Epidemiology and Biostatistics (C.T.M. van R., M.M.B.B., D.E.G.) and Public Health (C.T.M. van R., H. van de M., J.P.M.), Erasmus University Rotterdam, and Julius Center for Patient Oriented Research, Utrecht University (D.E.G.), the Netherlands.

Background and Purpose—We sought to assess the association between socioeconomic status and the risk of stroke among elderly women.

Methods—The association between socioeconomic status and stroke emerged in cross-sectional and longitudinal data on 4274 female participants of the Rotterdam Study, a prospective, population-based, follow-up study in the Netherlands among older subjects.

Results—A history of stroke was more common among women in lower socioeconomic strata. The same trend was observed for the relationship between the lowest socioeconomic groups and the incidence of stroke. Risk factors for stroke were not related to socioeconomic status in a consistent manner. Smoking, history of cardiovascular diseases, and overweight were more common in lower socioeconomic groups. However, socioeconomic differences in hypertension, antihypertensive drug use, prevalence of atrial fibrillation, and prevalence of left ventricular hypertrophy were not observed. The complex of established risk factors could only partly explain the association between socioeconomic status and stroke.

Conclusions—There is a strong association among elderly women between socioeconomic status and stroke. The association could only partly be explained by known risk factors. Our findings indicate that not only the actual risk profile but also risk factors earlier in life may be of importance.


Key Words: aged • risk factors • socioeconomic factors • stroke




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